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Organization
WELLMONT PHYSICIAN SERVICES INC
Active
Organization
WELLMONT PHYSICIAN SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY M LOCKE CPC CCS-P (BILLING ADMINISTRATOR)
(423) 224-3250
Entity
Organization
Contact information
Practice address
295 WHARTON LN NE, NORTON, VA 24273-1541
(276) 679-0321
(276) 679-2267
Mailing address
999 EXECUTIVE PARK BLVD, SUITE 201, KINGSPORT, TN 37660-4632
(423) 224-3250
(423) 224-3258
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023305000
FEDERAL BLACK LUNG
VA
01
—
1527279
UMWA
VA
01
—
608464000
DEPARTMENT OF LABOR
VA
05
—
65928152
—
KY
Enumeration date
03/27/2007
Last updated
04/22/2010
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