Organization
TRI CITY SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH M FORD (OFFICE PRACTICE ASSISTANT)
(804) 524-2294
Entity
Organization
Contact information
Practice address
930 SOUTH AVE, SUITE 4 A, COLONIAL HEIGHTS, VA 23834-3621
(804) 524-2294
(804) 524-0016
Mailing address
930 SOUTH AVE, SUITE 4 A, COLONIAL HEIGHTS, VA 23834-3621
(804) 524-2294
(804) 524-0016
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007301201
—
VA
05
—
007305826
—
VA
05
—
007385382
—
VA
01
—
027707
ANTHEM BCBS
—
01
—
051145
ANTHEM BCBS
—
01
—
110950
ANTHEM BCBS
—
Enumeration date
09/22/2006
Last updated
06/08/2016
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