| Dr. Mitz J. Sampson | |
|
211 Park Hill Dr Ste B Fredericksburg VA 22401-3361 | |
| (540) 370-4370 | |
| (540) 370-4331 |
| Full Name | Dr. Mitz J. Sampson |
|---|---|
| Speciality | Family Medicine |
| Location | 211 Park Hill Dr Ste B, Fredericksburg, Virginia |
| Authorized Official Name and Position | Mitzi J. Sampson (PHYSICIAN/PRESIDENT) |
| Authorized Official Contact | 5403704370 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Mitz J. Sampson 211 Park Hill Dr Ste B Fredericksburg VA 22401-3361 Ph: (540) 370-4370 | Dr. Mitz J. Sampson 211 Park Hill Dr Ste B Fredericksburg VA 22401-3361 Ph: (540) 370-4370 |
| NPI Number | 1669794921 |
|---|---|
| Provider Enumeration Date | 02/26/2010 |
| Last Update Date | 04/04/2025 |
| Certification Date | 04/04/2025 |
| Medicare PECOS PAC ID | 4880725977 |
|---|---|
| Medicare Enrollment ID | O20100707000138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669794921 | NPI | - | NPPES |
| 080006928 | Other | VA | MEDICARE PTAN |
| 5609127 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101047353 (Virginia) | Primary |
| Provider Name | Mitzi Jean Sampson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548256472 PECOS PAC ID: 0345371456 Enrollment ID: I20100706000035 |
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