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CENTRA MEDICAL GROUP LLC NPI 1013198779


NPI Information

NPI: 1013198779
Provider Name: CENTRA MEDICAL GROUP, LLC

Doing Business As: CENTRA MEDICAL GROUP SURGICAL SPECIALISTS

Classification: Colon & Rectal Surgery - 208C00000X
Entity Type: Organization
Address:
1906 THOMSON DR
LYNCHBURG, VA
ZIP 24501
Phone: (434) 947-3933
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CENTRA MEDICAL GROUP, LLC is a colon rectal surgery in Lynchburg, VA. The provider is a colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. CENTRA MEDICAL GROUP, LLC NPI is 1013198779. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Centra Medical Group Surgical Specialists.

The provider's business location address is:

1906 THOMSON DR
LYNCHBURG, VA
ZIP 24501-009
Phone: (434) 947-3933

The provider's authorized official is Lewis Addison .
The authorized official title is Director and has the following contact phone number (434) 200-5047.

The enumeration date for this NPI number is 11/21/2007 and was last updated on 10/16/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgeryNo
2208C00000XColon & Rectal SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C09704MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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