Organization
DOMINION MEDICAL ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ALLEN JACKSON M.D. (PRESEND)
(804) 225-7148
Entity
Organization
Contact information
Practice address
304 E LEIGH ST, RICHMOND, VA 23219-1410
(804) 225-7148
(804) 225-7159
Mailing address
PO BOX 5449, 304 EAST LEIGH STREET, RICHMOND, VA 23220-0449
(804) 225-7148
(804) 225-7159
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396826046
NPI GROUP NUMBER
VA
Enumeration date
10/18/2006
Last updated
03/19/2025
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