Provider Demographics
NPI:1497020226
Name:DLP TWIN COUNTY PHYSICIAN PRACTICES LLC
Entity Type:Organization
Organization Name:DLP TWIN COUNTY PHYSICIAN PRACTICES LLC
Other - Org Name:TWIN COUNTY FAMILY CARE CENTER OF HILLSVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JESS
Authorized Official - Middle Name:N
Authorized Official - Last Name:JUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-372-8500
Mailing Address - Street 1:702 PINE ST
Mailing Address - Street 2:
Mailing Address - City:HILLSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24343-1405
Mailing Address - Country:US
Mailing Address - Phone:276-728-4311
Mailing Address - Fax:276-728-0901
Practice Address - Street 1:702 PINE ST
Practice Address - Street 2:
Practice Address - City:HILLSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24343-1405
Practice Address - Country:US
Practice Address - Phone:276-728-4311
Practice Address - Fax:276-728-0901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty