Organization
BON SECOURS-VIRGINIA HEALTHSOURCE
Active
Other names
Ironbridge Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE O. BUTLER (DIR., CORPORATE RESPONSIBILITY)
(804) 281-0271
Entity
Organization
Contact information
Practice address
11601 IRON BRIDGE RD, SUITE 117, CHESTER, VA 23831
(804) 717-5300
(804) 748-7269
Mailing address
11601 IRON BRIDGE RD, SUITE 117, CHESTER, VA 23831-1466
(804) 717-5300
(804) 748-7269
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI1391
RAILROAD MEDICARE
VA
Enumeration date
07/08/2006
Last updated
07/27/2018
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