| Mecklenburg Family Practice | |
|
969 Madison St Boydton VA 23917-0297 | |
| (434) 738-6911 | |
| (434) 738-0431 |
| Full Name | Mecklenburg Family Practice |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 969 Madison St, Boydton, Virginia |
| Authorized Official Name and Position | Willoughby Shelton Hundley (PRESIDENT) |
| Authorized Official Contact | 4347386911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mecklenburg Family Practice Po Box 297 Boydton VA 23917-0297 Ph: (434) 738-6911 | Mecklenburg Family Practice 969 Madison St Boydton VA 23917-0297 Ph: (434) 738-6911 |
| NPI Number | 1427232735 |
|---|---|
| Provider Enumeration Date | 12/21/2007 |
| Last Update Date | 12/21/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427232735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Virginia) | Primary |
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