| Crossen Family Practice Pc | |
|
7603 Forest Ave Ste 301 Henrico VA 23229-4937 | |
| (804) 421-7404 | |
| (804) 421-7405 |
| Full Name | Crossen Family Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 7603 Forest Ave Ste 301, Henrico, Virginia |
| Authorized Official Name and Position | David Keith Crossen (OWNER/PROVIDER) |
| Authorized Official Contact | 8049211284 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossen Family Practice Pc 5805 River Rd Richmond VA 23226-3313 Ph: (804) 421-7404 | Crossen Family Practice Pc 7603 Forest Ave Ste 301 Henrico VA 23229-4937 Ph: (804) 421-7404 |
| NPI Number | 1861425464 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 09/06/2023 |
| Medicare PECOS PAC ID | 8921150111 |
|---|---|
| Medicare Enrollment ID | O20181231000863 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861425464 | NPI | - | NPPES |
| 5642990 | Medicaid | VA | |
| 117693 | Other | VA | ANTHEM BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | David K Crossen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205826260 PECOS PAC ID: 7113079302 Enrollment ID: I20090720000146 |
| Provider Name | Wendy Hendrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033699293 PECOS PAC ID: 5597004879 Enrollment ID: I20190304002467 |
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