Organization
RIVERSIDE PHYSICIAN SERVICES INC
Active
Parent organization
RIVERSIDE PHYSICIAN SERVICES INC
Other names
Elizabeth Lakes Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVERSIDE PHYSICIAN SERVICES INC
Authorized official
BILLIE JO BROWN (CREDENTIALING MANAGER)
(757) 316-5901
Entity
Organization
Contact information
Practice address
191 FOX HILL RD, HAMPTON, VA 23669-2360
(757) 850-1311
(757) 850-7315
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
(757) 594-4006
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/14/2006
Last updated
07/22/2024
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