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Organization
DANVILLE UROLOGIC CLINIC INC
Active
Organization
DANVILLE UROLOGIC CLINIC INC
Active
Other names
Southside Urology & Nephrology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH M CARBONE MD (PRESIDENT)
(434) 792-1433
Entity
Organization
Contact information
Practice address
1040 MAIN ST, DANVILLE, VA 24541-1816
(434) 792-1433
(434) 797-2807
Mailing address
1040 MAIN ST, P.O. BOX 1360, DANVILLE, VA 24541-1816
(434) 792-1433
(434) 797-2807
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
VA
208800000X
Urology Physician
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171773
ANTHEM GROUP NUMBER
VA
05
—
89016RW
—
NC
01
—
DC7953
RAILROAD MEDICARE
VA
Enumeration date
05/12/2006
Last updated
09/07/2023
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