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Organization
BRUNSWICK FAMILY PRACTICE LTD
Active
Organization
BRUNSWICK FAMILY PRACTICE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM H HARRISON III MD (PRESIDENT)
(434) 848-0072
Entity
Organization
Contact information
Practice address
319 WEST CHURCH STREET, LAWRENCEVILLE, VA 23868
(434) 848-0072
(434) 848-0141
Mailing address
POST OFFICE BOX 748, 319 WEST CHURCH STREET, LAWRENCEVILLE, VA 23868
(434) 848-0072
(434) 848-0141
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101038490
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005630576
—
VA
01
—
092366
ANTHEM BLUE CROSS BLUE SH
VA
Enumeration date
11/07/2006
Last updated
07/15/2008
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