Provider Demographics
NPI:1295746931
Name:NEIL SCHACHT MD HEMATOLOGY ONCOLOGY PRACTICE OF SOUTHSIDE VA PC
Entity type:Organization
Organization Name:NEIL SCHACHT MD HEMATOLOGY ONCOLOGY PRACTICE OF SOUTHSIDE VA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:YANCEY
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-575-1212
Mailing Address - Street 1:2232 WILBORN AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-1662
Mailing Address - Country:US
Mailing Address - Phone:434-575-1212
Mailing Address - Fax:434-575-1130
Practice Address - Street 1:2232 WILBORN AVE
Practice Address - Street 2:SUITE D
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-1662
Practice Address - Country:US
Practice Address - Phone:434-575-1212
Practice Address - Fax:434-575-1130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058614207RH0003X
VA0101239151207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08360Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER