Organization
RIVERSIDE PHYSICIAN SERVICES INC
Active
Parent organization
RIVERSIDE HEALTHCARE ASSOCIATES
Other names
Riverside Fishing Bay Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVERSIDE HEALTHCARE ASSOCIATES
Authorized official
JAMES LEESNICK MD (VICE PRESIDENT)
(757) 594-4006
Entity
Organization
Contact information
Practice address
16681 GENERAL PULLER HWY, DELTAVILLE, VA 23043-2006
(804) 776-8000
(804) 776-6211
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
(757) 594-4006
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
07/18/2006
Last updated
10/14/2014
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