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Organization
DOMINION HEALTH MEDICAL ASSOC.
Active
Organization
DOMINION HEALTH MEDICAL ASSOC.
Active
Other names
Sentora Halifax General Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
CECIL HAZELWOOD (MANAGER (SDHG))
(434) 517-3590
Entity
Organization
Contact information
Practice address
2212 WILBORN AVE, SOUTH BOSTON, VA 24592
(434) 517-3529
(434) 517-3887
Mailing address
P.O. BOX 860, SOUTH BOSTON, VA 24592
(434) 517-3513
(434) 517-3887
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/28/2013
Last updated
02/10/2015
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