Healthcare Provider Details

I. General information

NPI: 1740293216
Provider Name (Legal Business Name): JOHN HENRY VELYVIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 E CHURCH ST
MARTINSVILLE VA
24112-3225
US

IV. Provider business mailing address

1100 E CHURCH ST
MARTINSVILLE VA
24112-3225
US

V. Phone/Fax

Practice location:
  • Phone: 276-638-2354
  • Fax: 276-638-3398
Mailing address:
  • Phone: 276-638-2354
  • Fax: 276-638-3398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA92235
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberA92235
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0101266016
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number0101266016
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: