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General NPI Number Information
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NPI Number | 1871557009
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Entity Type | Individual
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Provider Name | JOSEPH BENNETT THIES M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 2900 LAMB CIRCLE SUITE L223
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073
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Country | US
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Telephone | 540-731-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 FALCON RIDGE ROAD
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City | BLACKSBURG
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State | VA
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Zip | 24060
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Country | US
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Telephone | 850-791-6460
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number | E4627
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101258921
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License Number State | VA
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