Mahoney Family Medicine | |
445 Commonwealth Blvd E Suite A Martinsville VA 24112-2086 | |
(276) 666-0500 | |
(276) 666-0400 |
Full Name | Mahoney Family Medicine |
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Speciality | Family Medicine |
Location | 445 Commonwealth Blvd E, Martinsville, Virginia |
Authorized Official Name and Position | Mark Thomas Mahoney (OWNER) |
Authorized Official Contact | 2766660500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mahoney Family Medicine Po Box 5544 Martinsville VA 24115-5544 Ph: (276) 666-0500 | Mahoney Family Medicine 445 Commonwealth Blvd E Suite A Martinsville VA 24112-2086 Ph: (276) 666-0500 |
NPI Number | 1356768097 |
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Provider Enumeration Date | 03/19/2014 |
Last Update Date | 03/19/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356768097 | NPI | - | NPPES |
49D1032709 | Other | VA | CLIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 0102201617 (Virginia) | Primary |
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