Healthcare Provider Details

I. General information

NPI: 1578821070
Provider Name (Legal Business Name): JMH EMERGENCY PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2012
Last Update Date: 01/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16000 JOHNSTON MEMORIAL DR
ABINGDON VA
24211-7659
US

IV. Provider business mailing address

PO BOX 538183
ATLANTA GA
30353-8183
US

V. Phone/Fax

Practice location:
  • Phone: 276-258-1000
  • Fax: 276-676-2631
Mailing address:
  • Phone: 866-916-5259
  • Fax: 231-922-4030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN L JETER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 276-258-1000