Provider Demographics
NPI:1811908437
Name:DUBLIN FAMILY PRACTICE PC
Entity type:Organization
Organization Name:DUBLIN FAMILY PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:MAYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-674-8805
Mailing Address - Street 1:4676 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:VA
Mailing Address - Zip Code:24084-3871
Mailing Address - Country:US
Mailing Address - Phone:540-674-8805
Mailing Address - Fax:540-674-8670
Practice Address - Street 1:4676 LEE HWY
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:VA
Practice Address - Zip Code:24084-3871
Practice Address - Country:US
Practice Address - Phone:540-674-8805
Practice Address - Fax:540-674-8670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACO3445Medicare PIN
VAC03445Medicare ID - Type Unspecified