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General NPI Number Information
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NPI Number | 1629035688
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Entity Type | Organization
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Legal Business Name | CHRISTIANSBURG FAMILY PRACTICE,PC
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 6 HICKOK ST
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073-3524
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Country | US
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Telephone | 540-382-6148
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Fax | 540-382-4191
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Provider Business Mailing Address
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Address Line | 6 HICKOK ST
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073-3524
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Country | US
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Telephone | 540-382-6148
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Fax | 540-382-4191
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH E JONES
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Credential | M.D.
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Telephone | 540-382-6148
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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 | 0101026426
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License Number State | VA
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