Family Medicine Of Blacksburg, LLC
Family Medicine in Blacksburg, VA. Organization (NPI-2).
NPI number1558550301
StatusActive
Last updated in NPPESOct 30, 2020
Details
- NPI
- 1558550301
- Entity type
- Organization (NPI-2)
- Legal business name
- Family Medicine Of Blacksburg, LLC
- Organization subpart
- No
- Enumeration date
- Oct 17, 2007
- Certification date
- Oct 30, 2020
- Last updated
- Oct 30, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
1645 N Main StBlacksburg, VA 24060-2554
Phone 540-552-1246 · Fax 540-552-1247
Mailing address
2000 Health Park DrBrentwood, TN 37027-4525
Phone 615-373-7600 · Fax 866-346-1426
Authorized official
William Tedrick Johnson
Group Vp/Ao
6153723375
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