Unknown Individual – Family Medicine Physician, NPI 1457322604
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1375, West Ridge Road, Petunia, Wytheville, Wythe County, Virginia, 24382, United States
WYTHEVILLE, VA 243825011
Phone: (276) 228-8686
Fax: (276) 228-7933
Type: Location
1230, North 11th Street, Wytheville, Wythe County, Virginia, 24382, United States
WYTHEVILLE, VA 243821208
Phone: (540) 228-8687
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 24382)
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