Fancy Gap Internal Medicine
Organization Active NPI Internal Medicine Physician · Fancy Gap, VA
NPI 1376940643 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1376940643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- FANCY GAP INTERNAL MEDICINE
- Practice address
- 1661 Turner Spur Rd
Fancy Gap, VA 24328-4365 - Phone
- (276) 728-0735
- Fax
- (276) 728-7717
- NPI assigned
- Dec 2, 2014
- Organization subpart
- No
Authorized official
- Name
- Susan Tracy Roberts, NP-C
- Title
- Nurse Practitioner
- Phone
- (336) 707-7734
Practitioners 1
-
Susan Tracy Roberts, NP-C
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | NC | Yes |
Addresses
Primary practice location
1661 Turner Spur Rd
Fancy Gap, VA 24328-4365
Mailing address
1661 Turner Spur Rd
Fancy Gap, VA 24328-4365
Phone (276) 728-0735
Other providers in Fancy Gap, VA
- Stephanie Marie Davis
- Fancy Gap Internal Medicine
- H & S Enterprises, Inc.
- Susan Lee Jones
- Allison Mitchell
- Susan Tracy Roberts
- John William Tracy
All providers in Fancy Gap, VA · Internal Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.