| |
1280a Main St Altavista VA 24517-1458 | |
(434) 309-1165 | |
Not Available |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 1280a Main St, Altavista, Virginia |
Authorized Official Name and Position | Arthur Leavitt (VP PHYSICIAN PRACTICE MANAGEMENT) |
Authorized Official Contact | 4342003656 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1204 Fenwick Dr Lynchburg VA 24502-2112 Ph: () - | 1280a Main St Altavista VA 24517-1458 Ph: (434) 309-1165 |
NPI Number | 1619912441 |
---|---|
Provider Enumeration Date | 06/17/2006 |
Last Update Date | 04/25/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619912441 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |