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NPI Code Detail

MEDICARE: HENRY E. BRIDGES JR. MD

MEDICARE: HENRY E. BRIDGES JR. MD
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
1208100000XPhysical Medicine & Rehabilitation Physician40044TN

General Provider Information

NPI Number : 1912998212
Entity Type Code : Individual
Provider Name (Legal Business Name) : HENRY E. BRIDGES JR. MD
Provider Business Mailing Address
First Line : PO BOX 4786
Second Line :
City : MARTINSVILLE
State : VA
Zip : 24115-4786
Country : US
Telephone Number : 276-666-7326
Fax Number : 276-666-7593
Provider Business Practice Location Address
First Line : 320 HOSPITAL DR
Second Line :
City : MARTINSVILLE
State : VA
Zip : 24112-1900
Country : US
Telephone Number : 276-666-7326
Fax Number : 276-666-7593
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2005
Last Update Date : 03/05/2009

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