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Organization

KING & QUEEN FAMILY PRACTICE INC

Active
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Organization

KING & QUEEN FAMILY PRACTICE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WILLIAM B GWATHMY MD (ADMINISTRATOR)
(804) 769-0103
Entity
Organization

Contact information

Practice address
142 SMITHFIELD ROAD, ST STEPHNS CH, VA 23148-0130
(804) 769-0103
(804) 769-0508
Mailing address
PO BOX 130, ST STEPHNS CH, VA 23148-0130
(804) 769-0103
(804) 769-0508

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—

Other

Enumeration date
10/27/2006
Last updated
06/01/2011
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