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Organization
CENTRA HEALTH INC
Active
Organization
CENTRA HEALTH INC
Active
Other names
Centra Health Physician Provider Group
Organization subpart
No
Provider details
NPI number
Authorized official
JOE Z KOONS (MANAGING DIRECTOR REVENUE CYCLE)
(434) 200-4758
Entity
Organization
Contact information
Practice address
3300 RIVERMONT AVE, LYNCHBURG, VA 24503-2030
(434) 200-4758
Mailing address
1204 FENWICK DR, LYNCHBURG, VA 24502-2112
(434) 200-4758
(434) 200-4763
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
—
NULL
207RH0003X
Hematology & Oncology Physician
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
06/28/2017
Last updated
06/28/2017
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