| Family Healthcare Of Wytheville, Pc | |
|
1040 Holston Rd Wytheville VA 24382-4107 | |
| (276) 227-0200 | |
| (276) 227-0202 |
| Full Name | Family Healthcare Of Wytheville, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1040 Holston Rd, Wytheville, Virginia |
| Authorized Official Name and Position | Larissa Shae Parks (OFFICE MANAGER) |
| Authorized Official Contact | 2762270200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Healthcare Of Wytheville, Pc 1040 Holston Rd Wytheville VA 24382-4107 Ph: (276) 227-0200 | Family Healthcare Of Wytheville, Pc 1040 Holston Rd Wytheville VA 24382-4107 Ph: (276) 227-0200 |
| NPI Number | 1346474707 |
|---|---|
| Provider Enumeration Date | 05/13/2009 |
| Last Update Date | 03/02/2021 |
| Medicare PECOS PAC ID | 7517011893 |
|---|---|
| Medicare Enrollment ID | O20090820000792 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346474707 | NPI | - | NPPES |
| 1346474707 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0102202346 (Virginia) | Primary |
| Provider Name | John M Harkless |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083870455 PECOS PAC ID: 5890849178 Enrollment ID: I20090820000782 |
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