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General NPI Number Information
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NPI Number | 1134290703
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Entity Type | Organization
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Legal Business Name | THOMAS W. FUTRELL,MD, PC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 907 GOOSE CREEK RD SUITE 103
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City | FISHERSVILLE
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State | VA
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Zip | 22939-2352
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Country | US
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Telephone | 540-213-2240
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Fax | 540-213-2242
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Provider Business Mailing Address
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Address Line | 907 GOOSE CREEK RD SUITE 103
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City | FISHERSVILLE
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State | VA
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Zip | 22939-2352
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Country | US
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Telephone | 540-213-2240
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Fax | 540-213-2242
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS WALTER FUTRELL
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Credential | M.D.
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Telephone | 540-213-2240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 0101058590
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License Number State | VA
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