Healthcare Provider Details

I. General information

NPI: 1124460811
Provider Name (Legal Business Name): DLP TWIN COUNTY PHYSICIAN PRACTICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 DOCTORS PARK
GALAX VA
24333-2276
US

IV. Provider business mailing address

106 DOCTORS PARK
GALAX VA
24333-2276
US

V. Phone/Fax

Practice location:
  • Phone: 276-236-3210
  • Fax: 276-236-8780
Mailing address:
  • Phone: 276-236-3210
  • Fax: 276-236-8780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

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