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925 Village Hwy Rustburg VA 24588-4591 | |
(434) 332-7367 | |
(434) 332-1757 |
Full Name | |
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Speciality | Family Medicine |
Location | 925 Village Hwy, Rustburg, Virginia |
Authorized Official Name and Position | Thomas W Eppes (PRESIDENT) |
Authorized Official Contact | 4345256964 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 2489 Forest VA 24551-6489 Ph: (434) 382-1139 | 925 Village Hwy Rustburg VA 24588-4591 Ph: (434) 332-7367 |
NPI Number | 1407936941 |
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Provider Enumeration Date | 10/17/2006 |
Last Update Date | 09/11/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407936941 | NPI | - | NPPES |
1528155892 | Other | VA | CVFP CORPORATE NPI |
CA2436 | Other | VA | MEDICARE RAILROAD |
C03658 | Other | VA | CVFP MCARE GROUP PTAN |
CI3834 | Other | VA | MEDICARE RAILROAD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |