Organization
VIRGINIA EM-I MEDICAL SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOYD R. WICKIZER MD (MEDICAL DIRECTOR)
(804) 862-5680
Entity
Organization
Contact information
Practice address
801 S ADAMS ST, PETERSBURG, VA 23803-5149
(804) 862-5680
Mailing address
2904 LEATHERWOOD WAY, MIDLOTHIAN, VA 23113-1413
(804) 378-6003
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
06/05/2006
Last updated
08/22/2020
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