Organization
RIDGELINE PHYSICIAN SERVICES, PLC
Active
Other names
Wellspring Specialty Clinic, Wellspring Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
CHARITY WOLF (DIRECTOR)
(540) 718-0861
Entity
Organization
Contact information
Practice address
891 WILLIS LN, CULPEPER, VA 22701-4373
(540) 825-4557
Mailing address
302 E DAVIS ST, CULPEPER, VA 22701-2808
(540) 321-4281
(540) 812-4902
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
—
207YX0602X
Otolaryngic Allergy Physician
—
—
208000000X
Pediatrics Physician
—
—
2084N0400X
Neurology Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP1100X
Podiatric Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952627119
—
VA
Enumeration date
04/13/2010
Last updated
06/14/2024
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