1212 Med PLLC
Organization Active NPI Family Medicine Physician · Richmond, VA
NPI 1982470100 · NPPES record last updated Mar 7, 2024
Key facts
- NPI
- 1982470100
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- 1212 MED PLLC
- Practice address
- 405 E Laburnum Ave Ste 3
Richmond, VA 23222-2134 - Phone
- (540) 200-8821
- Fax
- (540) 779-7889
- NPI assigned
- Nov 29, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. Henry Burgess, MD
- Title
- Owner
- Phone
- (540) 682-3082
Practitioners 1
-
Henry E Burgess, MD
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
405 E Laburnum Ave Ste 3
Richmond, VA 23222-2134
Mailing address
674 Lees Gap Rd
Fincastle, VA 24090-3869
Phone (540) 682-3082
Other names
- 1212MED
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All providers in Richmond, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.