Wellmont Physician Services Inc
Organization Active NPI Internal Medicine Physician · Mendota, VA
NPI 1497874150 · NPPES record last updated Apr 20, 2008
Key facts
- NPI
- 1497874150
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- WELLMONT PHYSICIAN SERVICES INC
- Practice address
- 2534 Mendota Rd
Mendota, VA 24270-2018 - Phone
- (276) 645-6710
- Fax
- (276) 645-6712
- NPI assigned
- Mar 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Cindy M Locke, CPC CCS-P
- Title
- Billing Administrator
- Phone
- (423) 224-3250
Corporate family (same tax ID) 15
Practitioners 1
National Provider Directory
- Tax ID family
- Wellmont Physician Services Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
2534 Mendota Rd
Mendota, VA 24270-2018
Mailing address
999 Executive Park Blvd
Suite 201
Kingsport, TN 37660-4632
Phone (423) 224-3250
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CC3164 | Other | VA | RAIL ROAD MEDICARE |
| 4409966 | Medicaid | TN | |
| 1527279 | Other | VA | UMWA |
Other names
- Mendota Medical Center
Other providers in Mendota, VA
All providers in Mendota, 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 Apr 20, 2008. 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.