# BRUNSWICK FAMILY PRACTICE LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235208711
- **Authorized official:** WILLIAM H HARRISON III MD (PRESIDENT)
- **Authorized official phone:** (434) 848-0072

## Contact information

- **Practice address:** 319 WEST CHURCH STREET, LAWRENCEVILLE, VA 23868
- **Practice address phone:** (434) 848-0072
- **Practice address fax:** (434) 848-0141
- **Mailing address:** POST OFFICE BOX 748, 319 WEST CHURCH STREET, LAWRENCEVILLE, VA 23868
- **Mailing address phone:** (434) 848-0072
- **Mailing address fax:** (434) 848-0141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0101038490 | VA | Yes |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 07/15/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 005630576 | — | VA |
| 01 | — | 092366 | ANTHEM BLUE CROSS BLUE SH | VA |