| Physician Associates Of Virginia Pc | |
|
4461 Starkey Road Suite 201 Roanoke VA 24018 | |
| (540) 345-4946 | |
| (540) 982-7164 |
| Full Name | Physician Associates Of Virginia Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4461 Starkey Road, Roanoke, Virginia |
| Authorized Official Name and Position | Marion C Olson (CEO) |
| Authorized Official Contact | 5407679610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Associates Of Virginia Pc 4461 Starkey Road Suite 201 Roanoke VA 24018 Ph: (540) 345-4946 | Physician Associates Of Virginia Pc 4461 Starkey Road Suite 201 Roanoke VA 24018 Ph: (540) 345-4946 |
| NPI Number | 1659319275 |
|---|---|
| Provider Enumeration Date | 06/04/2006 |
| Last Update Date | 04/21/2011 |
| Medicare PECOS PAC ID | 3870578214 |
|---|---|
| Medicare Enrollment ID | O20040621001202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659319275 | NPI | - | NPPES |
| Provider Name | Ezekiel N Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730129206 PECOS PAC ID: 0840186706 Enrollment ID: I20040318000480 |
| Provider Name | Bonnie F Culkin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982642930 PECOS PAC ID: 1557373545 Enrollment ID: I20060609000209 |
| Provider Name | Charlotte Hagan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861450868 PECOS PAC ID: 3779648696 Enrollment ID: I20090210000248 |
| Provider Name | Son H Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780866954 PECOS PAC ID: 6103978051 Enrollment ID: I20090723000468 |
| Provider Name | Carolyn Clark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033156617 PECOS PAC ID: 2860572997 Enrollment ID: I20100210000611 |
| Provider Name | Daniel Bauer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043257611 PECOS PAC ID: 9133262322 Enrollment ID: I20100210000627 |
| Provider Name | James H Gardner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073504452 PECOS PAC ID: 6709892854 Enrollment ID: I20100602001064 |
| Provider Name | Anne M Jaeger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497746887 PECOS PAC ID: 9436165586 Enrollment ID: I20100603000585 |
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