Individual
DR. WILLIAM JOHNSON IRVIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14051 ST FRANCIS BLVD, SUITE 2210, MIDLOTHIAN, VA 23114-3201
(804) 893-8717
(804) 594-3131
Mailing address
14051 ST FRANCIS BLVD, SUITE 2210, MIDLOTHIAN, VA 23114-3201
(804) 893-8717
(804) 594-3131
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
2006-00276
NC
207RH0003X
Hematology & Oncology Physician
Primary
0101251920
VA
207RH0003X
Hematology & Oncology Physician
2006-00276
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C09633
GROUP PTAN
VA
Enumeration date
03/22/2007
Last updated
07/05/2012
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