| Fork Union Medical Associates Inc | |
|
4064 James Madison Highway Fork Union VA 23055 | |
| (434) 842-3244 | |
| (434) 842-1110 |
| Full Name | Fork Union Medical Associates Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4064 James Madison Highway, Fork Union, Virginia |
| Authorized Official Name and Position | Randolph Ewing Lanford (CEO) |
| Authorized Official Contact | 4348423244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fork Union Medical Associates Inc 4064 James Madison Highway Po Box 458 Fork Union VA 23055 Ph: (434) 842-3244 | Fork Union Medical Associates Inc 4064 James Madison Highway Fork Union VA 23055 Ph: (434) 842-3244 |
| NPI Number | 1942393822 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 01/19/2010 |
| Medicare PECOS PAC ID | 0840397956 |
|---|---|
| Medicare Enrollment ID | O20070524000683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942393822 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101032081 (Virginia) | Primary |
| Provider Name | Randolph Ewing Lanford |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1720114226 PECOS PAC ID: 3476650581 Enrollment ID: I20101203000855 |
Fork Union Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4064 James Madison Highway, Fork Union, VA 23055 Phone: 434-842-3244 Fax: 434-842-1110 |