Healthcare Provider Details

I. General information

NPI: 1033485925
Provider Name (Legal Business Name): DLP TWIN COUNTY PHYSICIAN PRACTICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 HOSPITAL DR
GALAX VA
24333-2228
US

IV. Provider business mailing address

225 HOSPITAL DR
GALAX VA
24333-2228
US

V. Phone/Fax

Practice location:
  • Phone: 276-236-6909
  • Fax: 276-236-7179
Mailing address:
  • Phone: 276-236-6909
  • Fax: 276-236-7179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE LAWRENCE
Title or Position: SECRETARY
Credential:
Phone: 615-920-7000