NPI 1093967788

Vanessa O. Johnson,m.D.,pc

Organisation Primary Care Clinic/Center Petersburg, VA

Practice location

Address: 50 Medical Park Boulevard Suite B, Petersburg, VA 23805
Phone: (804) 732-7100
Fax: (804) 732-7101

Authorised official

Name: Vanessa O. Johnson
Title: President/Owner
Phone: (804) 732-7100

Registered specialties

Primary Care Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QP2300X Licence 0101039958 (VA)

Other Clinic/Center providers in Virginia →

Registry record

NPI: 1093967788
Entity type: Organization
NPI issued: 14 Oct 2008
Record last updated: 14 Oct 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.