MEDICARE: CLINCH VALLEY NEPHROLOGY,INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	0101029175	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295914679
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINCH VALLEY NEPHROLOGY,INC.

Provider Business Mailing Address
First Line	:	2951 FRONT ST
Second Line	:	CLINCH VALLEY MEDICAL PLAZA, SUITE 1600
City	:	RICHLANDS
State	:	VA
Zip	:	24641-2055
Country	:	US
Telephone Number	:	276-964-4001
Fax Number	:

Provider Business Practice Location Address
First Line	:	2951 FRONT ST
Second Line	:	CLINCH VALLEY MEDICAL PLAZA, SUITE 1600
City	:	RICHLANDS
State	:	VA
Zip	:	24641-2055
Country	:	US
Telephone Number	:	276-964-4001
Fax Number	:

Authorized Official
Title or Position	:	C.E.O.
Name	:	IN YOUNG PARK
Credential	:	M.D.
Telephone Number	:	276-964-4001

Provider Enumeration Date	:	11/01/2007
Last Update Date	:	11/01/2007

Similar Medicare Providers

1093758344 — ROXANNE M DECKER CRNA
Practice Location Address:

2951 FRONT ST , SUITE 3050
RICHLANDS, VA
24641-2055

Practice Phone: 276-963-8504
Practice Fax: 276-963-6642

1114955168 — CLINCH VALLEY UROLOGY, LLC
Practice Location Address:

6719 GOV G. C. PEERY HWY , SUITE 1800
RICHLANDS, VA
24641-2055

Practice Phone: 276-596-6659
Practice Fax: 276-596-6658

1033147061 — ORTHOPEDICS OF SOUTHWEST VIRGINIA, LLC
Practice Location Address:

6719 GOV G.C. PERRY HWY , SUITE 1000
RICHLANDS, VA
24641-2055

Practice Phone: 276-596-6715
Practice Fax: 276-596-6717

1730190653 — KENNETH FORBES HILL M.D.
Practice Location Address:

2951 FRONT ST , SUITE 2450
RICHLANDS, VA
24641-2055

Practice Phone: 276-596-6659
Practice Fax: 276-596-6658

1285647909 — GREGORY WADE WHEELER RPH
Practice Location Address:

2951 FRONT ST , SUITE 1850
RICHLANDS, VA
24641-2055

Practice Phone: 276-596-6600
Practice Fax: 276-596-6626

1760592323 — SOUTHWEST ANESTHESIA, PC
Practice Location Address:

2951 FRONT ST , STE 3050
RICHLANDS, VA
24641-2055

Practice Phone: 276-963-8504
Practice Fax: 276-963-6642

1194836296 — LYON TIGE HAZLETON CRNA
Practice Location Address:

2951 FRONT ST , SUITE 3050
RICHLANDS, VA
24641-2055

Practice Phone: 276-963-8504
Practice Fax: 276-963-6642

Directions to “CLINCH VALLEY NEPHROLOGY,INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.