# ADVANCED FAMILY PRACTICE

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

## Provider details

- **NPI number:** 1881792661
- **Authorized official:** DAVID ANTHONY CLARK M.D. (CHAIRMAN)
- **Authorized official phone:** (804) 347-4357

## Contact information

- **Practice address:** 11453 ABBOTS CROSS LN, GLEN ALLEN, VA 23059-1102
- **Practice address phone:** (804) 347-4357
- **Mailing address:** 11453 ABBOTS CROSS LN, GLEN ALLEN, VA 23059-1102
- **Mailing address phone:** (804) 347-4357

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0101032223 | VA | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 01/08/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 005647134 | — | VA |