General Thoracic Surgery PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

0101240724 Issued in VA

Legal business name

GENERAL THORACIC SURGERY PC

Practice address

3150 Clinch St
Suite 104
Richlands, VA 24641-2159

Phone

(276) 596-6715

Fax

(276) 596-6717

NPI assigned

Sep 19, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Olusola O Oduntan, MDNPI 1174592125

Title

Owner

Phone

(276) 596-6715

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olusola Oduntan, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Morgantown, WV
  • NPI 1174592125
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221782400000",
    "number": "1407006018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 CLINCH ST",
            "address_2": "SUITE 104",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "246412159",
            "telephone_number": "276-596-6715",
            "fax_number": "276-596-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 CLINCH ST",
            "address_2": "SUITE 104",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "246412159",
            "telephone_number": "276-596-6715",
            "fax_number": "276-596-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL THORACIC SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-19",
        "last_updated": "2008-09-19",
        "status": "A",
        "authorized_official_last_name": "ODUNTAN",
        "authorized_official_first_name": "OLUSOLA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-596-6715",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101240724",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "VA",
            "license": "0101240724",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1174592125",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bruce Michael Freedman, DPM
• Galen-Med, Inc.
• Galen-Med, Inc.
• Galen-Med, Inc.
• Gateway Drug Co., Inc
• James H Gibson III, PHARM,D.
• Barbara K. Gilbert, N.P.
• Glenn a. Harrison, P.C.
• Aparna Gogineni, M.D.
• Paul R Goyt, MD

• Surgery Physician in Richlands, VA
• Providers in Richlands, VA by specialty
• Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.