Provider Demographics
NPI:1649374968
Name:LEWIS-GALE PHYSICIANS, LLC
Entity type:Organization
Organization Name:LEWIS-GALE PHYSICIANS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OTIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:BLACKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-772-5992
Mailing Address - Street 1:1 ARH LANE
Mailing Address - Street 2:ALLEGHANY REGIONAL HOSPITAL
Mailing Address - City:LOW MOOR
Mailing Address - State:VA
Mailing Address - Zip Code:24457
Mailing Address - Country:US
Mailing Address - Phone:540-772-3707
Mailing Address - Fax:
Practice Address - Street 1:1 ARH LANE
Practice Address - Street 2:ALLEGHANY REGIONAL HOSPITAL
Practice Address - City:LOW MOOR
Practice Address - State:VA
Practice Address - Zip Code:24457
Practice Address - Country:US
Practice Address - Phone:540-772-3707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101030911207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty