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General NPI Number Information
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NPI Number | 1245342237
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Entity Type | Organization
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Legal Business Name | ROANOKE FAMILY MEDICINE
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | ROANOKE FAMILY MEDICINE INC
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City | ROANOKE
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State | VA
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Zip | 24015
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Country | US
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Telephone | 540-527-1198
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Fax | 540-344-7154
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Provider Business Mailing Address
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Address Line | PO BOX 4127 ROANOKE FAMILY MEDICINE INC
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City | ROANOKE
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State | VA
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Zip | 24015
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Country | US
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Telephone | 540-527-1198
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Fax | 540-344-7154
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KATHLEEN BAILEY BALL
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Credential |
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Telephone | 540-721-2014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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