Provider Demographics
NPI:1871654871
Name:INTERNAL MEDICINE SPECIALISTS OF EMPORIA, P.C.
Entity Type:Organization
Organization Name:INTERNAL MEDICINE SPECIALISTS OF EMPORIA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LELIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SLAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-634-9488
Mailing Address - Street 1:201 WEAVER AVE
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:VA
Mailing Address - Zip Code:23847-1248
Mailing Address - Country:US
Mailing Address - Phone:434-634-9488
Mailing Address - Fax:434-348-1094
Practice Address - Street 1:201 WEAVER AVE
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-1248
Practice Address - Country:US
Practice Address - Phone:434-634-9488
Practice Address - Fax:434-348-1094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC01065Medicare ID - Type UnspecifiedGROUP NUMBER
VAB06372Medicare UPIN