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General NPI Number Information
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NPI Number | 1881786630
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Entity Type | Organization
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Legal Business Name | FAMILY PRACTICE SPECIALISTS, PLLC
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 280 VIRGINIA AVE NE SUITE 106
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City | NORTON
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State | VA
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Zip | 24273-1538
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Country | US
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Telephone | 276-679-0899
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Fax | 276-679-0803
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Provider Business Mailing Address
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Address Line | 280 VIRGINIA AVE NE SUITE 106
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City | NORTON
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State | VA
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Zip | 24273-1538
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Country | US
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Telephone | 276-679-0899
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Fax | 276-679-0803
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | GEORGIA B THOMAS
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Credential |
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Telephone | 276-679-0899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101034800
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License Number State | VA
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