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General NPI Number Information
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NPI Number | 1487663035
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Entity Type | Organization
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Legal Business Name | HORIZON FAMILY MEDICINE OF BRISTOL, INC
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 103 BRISTOL EAST RD
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City | BRISTOL
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State | VA
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Zip | 24202-5501
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Country | US
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Telephone | 276-642-0623
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Fax | 276-642-0208
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Provider Business Mailing Address
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Address Line | 999 EXECUTIVE PARK BLVD SUITE 201
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City | KINGSPORT
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State | TN
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Zip | 37660-4632
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Country | US
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Telephone | 423-224-3250
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Fax | 423-224-3258
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Authorized Official
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Title or Position | PRACTICE MANAGER/OWNER
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Name | MR. MICHAEL KOVACS
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Credential |
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Telephone | 276-642-0623
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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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