Organization
PHYSICIAN ASSOCIATES OF CENTRAL VIRGINIA, LLC
Active
Parent organization
MEDICAL ASSOCIATES OF CENTRAL VIRGINIA, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICAL ASSOCIATES OF CENTRAL VIRGINIA, INC.
Authorized official
NICHOLAS CLEARY III (ADMINISTRATOR)
(434) 947-3944
Entity
Organization
Contact information
Practice address
2215 LANDOVER PL, LYNCHBURG, VA 24501-2115
(434) 947-3944
(866) 617-8273
Mailing address
2215 LANDOVER PL, LYNCHBURG, VA 24501-2115
(434) 947-3944
(866) 617-8273
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
0101043535
VA
2080P0006X
Developmental - Behavioral Pediatrics Physician
0101036819
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386921534
TRICARE
—
05
—
1386921534
—
VA
Enumeration date
11/15/2011
Last updated
01/15/2016
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