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Dominion Health Medical Assoc
Clinic/Center in South Boston, Virginia
NPI 1760740625

Dominion Health Medical Assoc is a Clinic/Center based in South Boston, VA. Dominion Health Medical Assoc practices in South Boston, VA. The NPI Number for Dominion Health Medical Assoc is 1760740625 and holds a License No. 0101251410 (Virginia).

The current practice location address for Dominion Health Medical Assoc is 2206 Wilborn Ave, South Boston, VA and can be reached out via phone at 434-517-8075 and via fax at 434-517-3887.

Location: 2206 Wilborn Ave, South Boston, VA, 24592
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1760740625
Provider Name
Dominion Health Medical Assoc
Credential
Provider Entity Type
Organization
Address
2206 Wilborn Ave, South Boston, VA, 24592
Phone Number
434-517-8075
Fax Number
434-517-3887
Provider Enumeration Date
04/30/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0101251410 01 VA LICENSE
institution
Provider Business Practice Location Address Details
Address
2206 Wilborn Ave
City
South Boston
State
Virginia
Zip
24592
Phone Number
434-517-8075
Fax Number
434-517-3887
person
Provider Business Mailing Address Details
Address
2206 Wilborn Ave
City
South Boston
State
Virginia
Zip
24592
Phone Number
434-517-8075
Fax Number
434-517-3887
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
0101251410 (Virginia)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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