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Organization
CENTRA MEDICAL GROUP, LLC
Active
Organization
CENTRA MEDICAL GROUP, LLC
Active
Parent organization
CENTRA MEDICAL GROUP, LLC
Other names
Centra Medical Group Bedford
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRA MEDICAL GROUP, LLC
Authorized official
JOSEPH KOONS (MANAGING DIRECTOR)
(434) 200-5047
Entity
Organization
Contact information
Practice address
1613 OAKWOOD ST, SUITE 201, BEDFORD, VA 24523-1213
(540) 586-7273
Mailing address
2010 ATHERHOLT RD, LYNCHBURG, VA 24501-1106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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