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General NPI Number Information
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NPI Number | 1497648661
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Entity Type | Organization
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Legal Business Name | MARTINSVILLE PRIMARY CARE LLC
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 106 SALMON ST
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City | MARTINSVILLE
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State | VA
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Zip | 24112-3211
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Country | US
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Telephone | 276-634-0010
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Fax | 276-632-0120
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Provider Business Mailing Address
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Address Line | 106 SALMON ST
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City | MARTINSVILLE
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State | VA
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Zip | 24112-3211
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Country | US
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Telephone | 276-634-0010
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Fax | 276-632-0120
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. EDYTHE ANNE BOITNOTT
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Credential | DNP
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Telephone | 276-618-1236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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