Organization
BON SECOURS ST. FRANCIS MEDICAL CENTER, INC.
Active
Other names
Blackstone Family Practice Center
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE O BUTLER (DIRECTOR CORPORATE REPONSIBILITY)
(804) 281-0271
Entity
Organization
Contact information
Practice address
213 N MAIN ST, BLACKSTONE, VA 23824-1425
(434) 292-7261
(434) 298-0908
Mailing address
213 N MAIN ST, BLACKSTONE, VA 23824-1425
(434) 292-7261
(434) 298-0908
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C09633
GROUP PTAN
VA
Enumeration date
11/15/2011
Last updated
12/19/2011
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