Provider Demographics
NPI:1972574861
Name:VOEKLER, SUSANNE (MD)
Entity Type:Individual
Prefix:
First Name:SUSANNE
Middle Name:
Last Name:VOEKLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 HEALTH PARK DR FL HP2
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4525
Mailing Address - Country:US
Mailing Address - Phone:540-615-7600
Mailing Address - Fax:
Practice Address - Street 1:65 SHENANDOAH AVE
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24083-3201
Practice Address - Country:US
Practice Address - Phone:540-966-6430
Practice Address - Fax:540-966-1348
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054814207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00287616OtherMEDICARE RAILROAD
VA005835852Medicaid
VA00W698L24Medicare ID - Type UnspecifiedRICHMOND MEDICARE