Provider Demographics
NPI:1396775193
Name:HESS ORTHOPAEDIC CENTER AND SPORTS MEDICINE, PLC
Entity type:Organization
Organization Name:HESS ORTHOPAEDIC CENTER AND SPORTS MEDICINE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:A
Authorized Official - Last Name:AGRICOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-434-1664
Mailing Address - Street 1:4165 QUARLES CT
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3576
Mailing Address - Country:US
Mailing Address - Phone:540-434-1664
Mailing Address - Fax:540-433-5931
Practice Address - Street 1:4165 QUARLES CT
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3576
Practice Address - Country:US
Practice Address - Phone:540-434-1664
Practice Address - Fax:540-433-5931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC04796Medicare ID - Type Unspecified
VA0636510001Medicare NSC