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General NPI Number Information
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NPI Number | 1285719823
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Entity Type | Organization
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Legal Business Name | JEWELL MEDICAL PC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 1 ARH LN SUITE 201
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City | LOW MOOR
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State | VA
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Zip | 24457
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Country | US
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Telephone | 540-863-4444
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 236
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City | LOW MOOR
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State | VA
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Zip | 24457-0236
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Country | US
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Telephone | 540-863-4444
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. MARY C MCCOIG
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Credential |
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Telephone | 540-862-6849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101235892
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License Number State | VA
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