Healthcare Provider Details

I. General information

NPI: 1336340447
Provider Name (Legal Business Name): COMMUNITY PHYSICIANS SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 15TH ST NW
NORTON VA
24273-1616
US

IV. Provider business mailing address

96 15TH ST NW SUITE 104
NORTON VA
24273-1620
US

V. Phone/Fax

Practice location:
  • Phone: 276-679-9645
  • Fax: 276-679-9762
Mailing address:
  • Phone: 276-679-8890
  • Fax: 276-679-9740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMILY JANE STURGILL
Title or Position: PRACTICE MANAGER
Credential:
Phone: 276-679-8890