Healthcare Provider Details

I. General information

NPI: 1104894526
Provider Name (Legal Business Name): JAMES PARKER SENTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 03/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7523 DC CANEY RIDGE RD
COEBURN VA
24230-4936
US

IV. Provider business mailing address

7523 DC CANEY RIDGE RD
COEBURN VA
24230-4936
US

V. Phone/Fax

Practice location:
  • Phone: 276-835-9731
  • Fax: 276-835-1007
Mailing address:
  • Phone: 276-835-9731
  • Fax: 276-926-4782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101032888
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101032888
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: