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General NPI Number Information
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NPI Number | 1811996572
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Entity Type | Organization
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Legal Business Name | LYNCHBURG INTERNAL MEDICINE INC
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1901 THOMSON DR
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City | LYNCHBURG
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State | VA
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Zip | 24501-1008
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Country | US
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Telephone | 434-947-3908
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Fax | 434-947-5948
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Provider Business Mailing Address
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Address Line | 1901 THOMSON DR
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City | LYNCHBURG
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State | VA
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Zip | 24501-1008
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Country | US
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Telephone | 434-947-3908
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Fax | 434-947-5948
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS CAROL P HARRIS
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Credential |
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Telephone | 434-947-3908
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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 | 0101021078
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License Number State | VA
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