Organization
GOOCHLAND FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANK BAIN MD (LEAD PHYSICIAN)
(804) 556-6101
Entity
Organization
Contact information
Practice address
2948 RIVER ROAD WEST, GOOCHLAND, VA 23063-0669
(804) 556-6101
(804) 556-6468
Mailing address
PO BOX 669, GOOCHLAND, VA 23063-0669
(804) 556-6101
(804) 556-6468
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101029901
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
052071
ANTHEM
VA
05
—
5671175
—
VA
Enumeration date
07/20/2006
Last updated
08/22/2020
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