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

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
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 Doing business as

Other providers in Richmond, VA

All providers in Richmond, VA · Family Medicine Physician in Virginia

Sources for this page

Verify at the official NPI Registry.