Provider Demographics
NPI:1912451873
Name:WESTWOOD FAMILY MEDICINE PLLC
Entity Type:Organization
Organization Name:WESTWOOD FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HIEP
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:678-897-1375
Mailing Address - Street 1:PO BOX 933
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-0933
Mailing Address - Country:US
Mailing Address - Phone:678-897-1375
Mailing Address - Fax:
Practice Address - Street 1:12 WESTWOOD MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-2000
Practice Address - Country:US
Practice Address - Phone:678-897-1375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA56317715207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty