Provider Demographics
NPI:1235104373
Name:LE NOACH, PHILIP M (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:M
Last Name:LE NOACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 927
Mailing Address - Street 2:5 E ALVON ROAD, SUITE 7
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986-2373
Mailing Address - Country:US
Mailing Address - Phone:304-536-5030
Mailing Address - Fax:304-536-5031
Practice Address - Street 1:800 OAK STREET
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-1199
Practice Address - Country:US
Practice Address - Phone:434-315-2850
Practice Address - Fax:434-392-8191
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235244207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10039384OtherOPTIMA/SENTARA
VA4265678OtherCIGNA
VA010018242Medicaid
VA3115917OtherUHC/MAMSI
VAP00687136Medicare PIN
G89971Medicare UPIN
VA018485C59Medicare PIN