| Surry Family Practice | |
|
401 Hopewell St Hopewell VA 23860-2817 | |
| (804) 458-6396 | |
| (804) 458-4934 |
| Full Name | Surry Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 401 Hopewell St, Hopewell, Virginia |
| Authorized Official Name and Position | June Rebecca Tunstall (OWNER) |
| Authorized Official Contact | 8044586396 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Surry Family Practice 401 Hopewell St Hopewell VA 23860-2817 Ph: (804) 458-6396 | Surry Family Practice 401 Hopewell St Hopewell VA 23860-2817 Ph: (804) 458-6396 |
| NPI Number | 1164402459 |
|---|---|
| Provider Enumeration Date | 01/20/2006 |
| Last Update Date | 11/06/2007 |
| Medicare PECOS PAC ID | 0143215210 |
|---|---|
| Medicare Enrollment ID | O20040417000581 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164402459 | NPI | - | NPPES |
| 5650569 | Medicaid | VA | |
| 5679818 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101029877 (Virginia) | Primary |
| Provider Name | June R Tunstall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316927767 PECOS PAC ID: 9335209089 Enrollment ID: I20081125000536 |
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