Provider Demographics
NPI:1851461479
Name:GEORGE A ROUSSEL & GENE L YODER & PHILIP W DAY PTRS
Entity Type:Organization
Organization Name:GEORGE A ROUSSEL & GENE L YODER & PHILIP W DAY PTRS
Other - Org Name:HARRISONBURG INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:ROUSSEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-433-6967
Mailing Address - Street 1:1937 MEDICAL AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3437
Mailing Address - Country:US
Mailing Address - Phone:540-433-6967
Mailing Address - Fax:540-433-1328
Practice Address - Street 1:1937 MEDICAL AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3437
Practice Address - Country:US
Practice Address - Phone:540-433-6967
Practice Address - Fax:540-433-1328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101026546207R00000X
VA0101029805207R00000X
VA0101044744207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6035451Medicaid
VA6004652Medicaid
VA6004598Medicaid
VA6004652Medicaid
VA6004598Medicaid
VA6035451Medicaid
VA6004652Medicaid
VAA15778Medicare UPIN
VA110003283Medicare ID - Type UnspecifiedDR DAY