Provider Demographics
| NPI: | 1124522404 |
|---|---|
| Name: | DLP TWIN COUNTY PHYSICIAN PRACTICES, LLC |
| Entity type: | Organization |
| Organization Name: | DLP TWIN COUNTY PHYSICIAN PRACTICES, LLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DIRECTOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | SARA |
| Authorized Official - Middle Name: | L |
| Authorized Official - Last Name: | MILLER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 615-920-7514 |
| Mailing Address - Street 1: | 330 SEVEN SPRINGS WAY |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BRENTWOOD |
| Mailing Address - State: | TN |
| Mailing Address - Zip Code: | 37027-5098 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 615-920-7000 |
| Mailing Address - Fax: | 615-920-8775 |
| Practice Address - Street 1: | 225 HOSPITAL DR |
| Practice Address - Street 2: | |
| Practice Address - City: | GALAX |
| Practice Address - State: | VA |
| Practice Address - Zip Code: | 24333-2228 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 276-236-6906 |
| Practice Address - Fax: | 276-236-7179 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2018-03-21 |
| Last Update Date: | 2018-03-21 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |