Blue Ridge Podiatry Associates | |
390 S Main St Ste 103, Rocky Mount, VA 24151-1767 | |
(540) 483-7933 | |
(540) 463-9454 |
Full Name | Blue Ridge Podiatry Associates |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 390 S Main St Ste 103, Rocky Mount, Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952390221 | NPI | - | NPPES |
009301283 | Medicaid | VA | |
009301208 | Medicaid | VA | |
0518620002 | Other | VA | NSC LEXINGTON LOCATION |
0518620001 | Other | VA | NSC STAUNTON LOCATION |
CM9184 | Other | VA | RR MEDICARE GROUP |
009301747 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 0103000391 (Virginia) | Primary |
213E00000X | Podiatrist | 0103000371 (Virginia) | Secondary |
213E00000X | Podiatrist | 0103300877 (Virginia) | Secondary |
Mailing Address | Practice Location Address |
---|---|
Blue Ridge Podiatry Associates Po Box 4205, Eden, NC 27289-4205 Ph: (336) 623-4545 | Blue Ridge Podiatry Associates 390 S Main St Ste 103, Rocky Mount, VA 24151-1767 Ph: (540) 483-7933 |
John Larry Clements, D.P.M. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 390 S Main St, Suite 103, Rocky Mount, VA 24151 Phone: 540-725-1226 Fax: 540-857-5306 |