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General NPI Number Information
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NPI Number | 1861355869
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Entity Type | Organization
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Legal Business Name | CENTRA MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 1922 THOMSON DR
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City | LYNCHBURG
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State | VA
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Zip | 24501-1019
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Country | US
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Telephone | 434-846-4444
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Fax | 434-846-4445
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Provider Business Mailing Address
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Address Line | PO BOX 749387
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City | ATLANTA
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State | GA
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Zip | 30374-9387
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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 | REV CYCLE MANAGER
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Name | JOSHUA LARKIN
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Credential |
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Telephone | 434-200-5047
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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 |
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License Number State |
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