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General NPI Number Information
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NPI Number | 1851058028
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Entity Type | Organization
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Legal Business Name | HOPE PRIMARY & URGENT CARE OF WILLIAMSBURG PLLC
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Dates
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Enumeration Date | 11/23/2021
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 896 S HIGHWAY 25W
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City | WILLIAMSBURG
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State | KY
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Zip | 40769
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Country | US
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Telephone | 606-515-6124
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Fax | 606-515-6163
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Provider Business Mailing Address
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Address Line | PO BOX 68
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City | STEARNS
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State | KY
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Zip | 42647-0068
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAMES CARROLL CORDER
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Credential |
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Telephone | 606-515-6124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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