Sentara Halifax Neurology | |
2206 Wilborn Ave South Boston VA 24592 | |
(434) 517-8075 | |
(434) 517-3887 |
Full Name | Sentara Halifax Neurology |
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Speciality | Clinic/center |
Location | 2206 Wilborn Ave, South Boston, Virginia |
Authorized Official Name and Position | Cecil Hazelwood (MANAGER (SDHG)) |
Authorized Official Contact | 4345173515 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Sentara Halifax Neurology P.o. Box 860 South Boston VA 24592 Ph: (434) 517-3513 | Sentara Halifax Neurology 2206 Wilborn Ave South Boston VA 24592 Ph: (434) 517-8075 |
NPI Number | 1760740625 |
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Provider Enumeration Date | 04/30/2012 |
Last Update Date | 02/10/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760740625 | NPI | - | NPPES |
0101251410 | Other | VA | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 0101251410 (Virginia) | Primary |
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