# APPALACHIA MEDICAL CLINIC, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760613996
- **Authorized official:** DR. MICHAEL B FORD MD (OWNER)
- **Authorized official phone:** (276) 565-2425

## Contact information

- **Practice address:** 127 CALLAHAN AVE, APPALACHIA, VA 24216-1203
- **Practice address phone:** (276) 565-2425
- **Mailing address:** 127 CALLAHAN AVE, APPALACHIA, VA 24216-1203
- **Mailing address phone:** (276) 565-2425

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0101020991 | VA | Yes |

## Other

- **Enumeration date:** 08/05/2009
- **Last updated:** 08/25/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 005639531 | — | VA |
| 05 | — | 64662299 | — | KY |