Healthcare Provider Details

I. General information

NPI: 1811908437
Provider Name (Legal Business Name): DUBLIN FAMILY PRACTICE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 06/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4676 LEE HWY
DUBLIN VA
24084-3871
US

IV. Provider business mailing address

4676 LEE HWY
DUBLIN VA
24084-3871
US

V. Phone/Fax

Practice location:
  • Phone: 540-674-8805
  • Fax: 540-674-8670
Mailing address:
  • Phone: 540-674-8805
  • Fax: 540-674-8670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM F. MAYO
Title or Position: PRESIDENT
Credential: MD
Phone: 540-674-8805