Organization
TRI-CITY MULTI-SPECIALTY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM TEDRICK JOHNSON (VICE PRESIDENT)
(804) 237-7760
Entity
Organization
Contact information
Practice address
906 CROSSINGS BLVD, SUITE C, HOPEWELL, VA 23860-6503
(804) 415-5000
(804) 415-5015
Mailing address
906 CROSSINGS BLVD, SUITE C, HOPEWELL, VA 23860-6503
(804) 415-5000
(804) 415-5015
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134450448
—
VA
Enumeration date
01/26/2010
Last updated
09/07/2010
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