Basic Information
| Provider Information | |||||||||
| NPI: | 1437194289 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTRAL VIRGINIA ORTHOPAEDICS & SPORTS MEDICINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 PARK HILL DR | ||||||||
| Address2: | |||||||||
| City: | FREDERICKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 224013377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5403726737 | ||||||||
| FaxNumber: | 5403723510 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 PARK HILL DR | ||||||||
| Address2: | |||||||||
| City: | FREDERICKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 224013377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5403726737 | ||||||||
| FaxNumber: | 5403723510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2006 | ||||||||
| LastUpdateDate: | 02/09/2021 | ||||||||
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| AuthorizedOfficialLastName: | CHANCE | ||||||||
| AuthorizedOfficialFirstName: | SHAWN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5403726737 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.