Organization
MOBJACK MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANCIS THORNTON WEST III M.D. (PRESIDENT)
(804) 684-5043
Entity
Organization
Contact information
Practice address
6506 MAIN ST, GLOUCESTER, VA 23061-6103
(804) 684-5043
Mailing address
6506 MAIN ST, GLOUCESTER, VA 23061-6103
(804) 684-5043
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101242168
VA
207R00000X
Internal Medicine Physician
0101242319
VA
Other
Enumeration date
02/07/2013
Last updated
02/07/2013
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