Provider Demographics
NPI:1386689230
Name:MOLONY, PATRICK A (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:A
Last Name:MOLONY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:105 W STONE DR
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-3365
Mailing Address - Country:US
Mailing Address - Phone:423-408-7220
Mailing Address - Fax:423-408-7405
Practice Address - Street 1:127 HEALTH CARE DR
Practice Address - Street 2:SUITE 8
Practice Address - City:PENNINGTON GAP
Practice Address - State:VA
Practice Address - Zip Code:24277-2853
Practice Address - Country:US
Practice Address - Phone:276-546-5212
Practice Address - Fax:276-546-1525
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2013-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101022999207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007610815Medicaid
VA007610807Medicaid
VA005824729Medicaid
VA493863Medicare Oscar/Certification
VA110007387Medicare PIN
VAB07172Medicare UPIN
VA005824729Medicaid
VA007610807Medicaid