Provider Demographics
NPI:1851058028
Name:HOPE PRIMARY & URGENT CARE OF WILLIAMSBURG PLLC
Entity Type:Organization
Organization Name:HOPE PRIMARY & URGENT CARE OF WILLIAMSBURG PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CARROLL
Authorized Official - Last Name:CORDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-515-6124
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:STEARNS
Mailing Address - State:KY
Mailing Address - Zip Code:42647-0068
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:896 S HIGHWAY 25W
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:KY
Practice Address - Zip Code:40769
Practice Address - Country:US
Practice Address - Phone:606-515-6124
Practice Address - Fax:606-515-6163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-23
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care