| Nansemond Family Practice, Llc | |
|
206 Gumwood Dr Suite A Smithfield VA 23430-6087 | |
| (757) 365-9090 | |
| (757) 365-9095 |
| Full Name | Nansemond Family Practice, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 206 Gumwood Dr, Smithfield, Virginia |
| Authorized Official Name and Position | Donald Elwood Soles (MEMBER) |
| Authorized Official Contact | 7573659090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nansemond Family Practice, Llc 206 Gumwood Dr Suite A Smithfield VA 23430-6087 Ph: (757) 365-9090 | Nansemond Family Practice, Llc 206 Gumwood Dr Suite A Smithfield VA 23430-6087 Ph: (757) 365-9090 |
| NPI Number | 1245313857 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 01/14/2011 |
| Medicare PECOS PAC ID | 9931386414 |
|---|---|
| Medicare Enrollment ID | O20110609000480 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245313857 | NPI | - | NPPES |
| 24513 | Other | VA | OPTIMA HEALTH/SENTARA |
| 005600367 | Medicaid | VA | |
| 431477 | Other | VA | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101045475 (Virginia) | Primary |
| Provider Name | Donald Elwood Soles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154312247 PECOS PAC ID: 9335220276 Enrollment ID: I20080116000546 |
Smithfield Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 919 S Church St, Smithfield, VA 23430 Phone: 757-356-9137 | |
Riverside Physician Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 Benns Church Blvd, Smithfield, VA 23430 Phone: 757-674-9050 Fax: 757-674-9099 | |
Riverside Physician Services, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1807 S Church St, Ste 114, Smithfield, VA 23430 Phone: 757-599-6333 Fax: 757-591-7261 | |
Riverside Physician Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19375 Benns Grant Blvd, Smithfield, VA 23430 Phone: 757-674-8700 Fax: 757-674-8825 | |
Family Medical Care Of Smithfield Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 Gumwood Dr, Smithfield, VA 23430 Phone: 757-357-3331 Fax: 757-357-6635 | |
Commonwealth Of Virginia State Board Of Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 919 S Church St, Smithfield, VA 23430 Phone: 757-357-4177 Fax: 757-357-2838 |