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Organization

LIBERTY MOUNTAIN MEDICAL GROUP

Active
Parent organization
CENTRAL VIRGINIA FAMILY PHYSICIANS, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
CENTRAL VIRGINIA FAMILY PHYSICIANS, INC.
Authorized official
KAREN L HAYNES (STAFF CREDENTIALING MANAGER)
(434) 382-1139
Entity
Organization

Contact information

Practice address
2321 WARDS RD, LYNCHBURG, VA 24502-2101
(434) 582-2273
(434) 582-1363
Mailing address
2321 WARDS RD, LYNCHBURG, VA 24502-2101
(434) 582-2273
(434) 582-1363

Taxonomy

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

Other

Enumeration date
03/03/2015
Last updated
03/30/2016
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