FRAZIER T FORTENBERRY JR MD PLC (NPI# 1215960224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215960224 |
| Entity Type | Organization |
| Organization Name | FRAZIER T FORTENBERRY JR MD PLC |
| Practice Address |
630 Peter Jefferson Pkwy Suite 135 Charlottesville VA 22911-8605 |
| Practice Telephone | 4342445722 |
| Practice Fax Number | 4342445723 |
| Mailing Telephone | 4342445722 |
| Mailing Fax Number | 4342445723 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2011-08-09 |
| Authorized Official Name | DR. FRAZIER T FORTENBERRY JR. (OWNER) |
| Authorized Official Telephone | 4342445722 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE PIN | DA1531 | 01 |
| Street Address |
630 PETER JEFFERSON PKWY SUITE 135 |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22911-8605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376530816 | Frazier T Fortenberry Jr. | Urology | 630 Peter Jefferson Pkwy, Suite 135, Charlottesville, VA 22911-8605 | 2005-09-30 |
| 1659782902 | Abc Therapy,llc | Physical Medicine & Rehabilitation | 630 Peter Jefferson Pkwy, Charlottesville, VA 22911-8605 | 2014-05-08 |
| 1487961967 | Adam James Sweeney | Optometrist | 630 Peter Jefferson Pkwy, Suite 180, Charlottesville, VA 22911-8605 | 2010-09-07 |
| 1356554034 | Tlc Whitten Laser Eye Associates, LLC | Clinic/Center | 630 Peter Jefferson Pkwy, Ste. 180, Charlottesville, VA 22911-8605 | 2007-05-08 |
| 1497765226 | Osteopathic Physicians of Charlottesville | Pain Medicine | 630 Peter Jefferson Pkwy, Suite 170, Charlottesville, VA 22911-8605 | 2006-08-08 |
| 1295787539 | Oculoplastics and Orbital Consultants Plc | Ophthalmology | 630 Peter Jefferson Pkwy, Suite 140, Charlottesville, VA 22911-8605 | 2006-05-16 |
| 1841263670 | Sara Alice Kaltreider | Ophthalmology | 630 Peter Jefferson Pkwy, Suite 140, Charlottesville, VA 22911-8605 | 2006-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760840912 | Hearing At Home | Hearing Instrument Specialist | 103 Free Brige Ln, Charlottesville, VA 22911 | 2016-02-03 |
| 1649637752 | Ebony Cosby | Contractor | 2500 Boulders Rd, Charlottesville, VA 22911 | 2016-01-20 |
| 1629452727 | Ahmed M Murtuza | Pharmacist | 925 Dorchester Pl Apt. 103, Charlottesville, VA 22911 | 2015-07-17 |
| 1083093231 | Kimberly P Tran | Dentist | 1470 Pantops Mountain Pl Ste 1, Charlottesville, VA 22911 | 2015-05-20 |
| 1508252982 | Alexandra M Bender | Family Medicine | 3263 Proffit Rd Ste 201, Charlottesville, VA 22911 | 2015-04-13 |
| 1538599980 | Commonwealth Dental Anesthesiology Inc | Clinic/Center | 1460-b Pantops Mountain Place, Charlottesville, VA 22911 | 2013-11-21 |
| 1831386606 | Hudson Chiropractic P.C. | Chiropractor | 103-a Free Bridge Lane, Charlottesville, VA 22911 | 2007-09-26 |
| 1386863421 | Laura P Smith | Specialist | 595 Peter Jefferson Parkway Suite 390, Reproductive Medicine and Surgery Center of Va, Charlottesville, VA 22911 | 2007-04-25 |
| 1609928621 | Bl Enterprises, LLC | Physical Therapist | 1405 Rolkin Court, Suite 102, Charlottesville, VA 22911 | 2007-01-18 |
| 1972660959 | Kenneth I. Barron | Obstetrics & Gynecology | 630 Peter Jefferson Pkwy Ste 140b, Charlottesville, VA 22911 | 2007-01-02 |
| Find all providers in zip 22911 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386713907 | Raymond A. Costabile | Urology | 500 Ray C Hunt Dr Fl 3, Charlottesville, VA 22903-2981 | 2006-11-07 |
| 1538148259 | Julian Claus Fagerli | Urology | 155 Riverbend Dr, Charlottesville, VA 22911-8607 | 2006-01-11 |
| 1376530816 | Frazier T Fortenberry Jr. | Urology | 630 Peter Jefferson Pkwy, Suite 135, Charlottesville, VA 22911-8605 | 2005-09-30 |
| 1962921650 | Jeena Kurian | Urology | 500 Ray C Hunt Dr Fl 3, Charlottesville, VA 22903-2981 | 2017-09-13 |
| 1720505019 | Latasha Ann-pegram Dunford | Urology | 500 Ray C Hunt Dr Fl 3, Charlottesville, VA 22903-2981 | 2017-08-28 |
| 1699296558 | Susan V. Leroy | Urology | 1204 W Main St, Charlottesville, VA 22903-2824 | 2017-06-30 |
| 1396150306 | Hamza Mustafa Beano | Urology | 500 Ray C Hunt Dr, Charlottesville, VA 22903-2981 | 2014-06-27 |
| 1407122427 | Jonathan A Israel | Urology | 155 Riverbend Dr, Charlottesville, VA 22911-8607 | 2012-03-23 |
| 1538455191 | Sumit Isharwal | Urology | 500 Ray C Hunt Dr Fl 3, Charlottesville, VA 22903 | 2011-06-22 |
| 1366758500 | Patience A. Oteng | Urology | 500 Ray C Hunt Dr Fl 3, Charlottesville, VA 22903-2981 | 2010-08-25 |
| Find all providers in CHARLOTTESVILLE | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22911 |
Please comment or provide details below to improve the information on FRAZIER T FORTENBERRY JR MD PLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.