Provider Demographics
NPI:1396376604
Name:VELYVIS ORTHOPEDICS
Entity Type:Organization
Organization Name:VELYVIS ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:VELYVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-835-7317
Mailing Address - Street 1:120 PROFESSIONAL PARK DR SE STE 7
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-6739
Mailing Address - Country:US
Mailing Address - Phone:540-242-0845
Mailing Address - Fax:540-242-0845
Practice Address - Street 1:120 PROFESSIONAL PARK DR SE STE 7
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6739
Practice Address - Country:US
Practice Address - Phone:540-242-0845
Practice Address - Fax:540-242-0845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty