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Organization

RIDGELINE PHYSICIAN SERVICES, LLC

Active
Other names
Wellspring Health Services
Organization subpart
No

Provider details

NPI number
Authorized official
BARBARA J DIXON (CREDENTIALING)
(540) 321-4281
Entity
Organization

Contact information

Practice address
15237 CREATIVITY DR, CULPEPER, VA 22701-2504
(540) 321-4281
(540) 321-4282
Mailing address
302 E DAVIS ST STE 201, CULPEPER, VA 22701-2808
(543) 321-4281

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
207LP2900X
Pain Medicine (Anesthesiology) Physician
207Q00000X
Family Medicine Physician
207QA0000X
Adolescent Medicine (Family Medicine) Physician
207QG0300X
Geriatric Medicine (Family Medicine) Physician
207VG0400X
Gynecology Physician
207Y00000X
Otolaryngology Physician
261Q00000X
Clinic/Center
261QM1300X
Multi-Specialty Clinic/Center
Primary
332900000X
Non-Pharmacy Dispensing Site

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1952627119
VA
Enumeration date
04/07/2017
Last updated
01/30/2020
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