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Organization
DICKENSON MEDICAL ASSOCIATES A DEPARTMENT OF DICKENSON COMMUNITY HOSPI
Active
Organization
DICKENSON MEDICAL ASSOCIATES A DEPARTMENT OF DICKENSON COMMUNITY HOSPI
Active
Parent organization
DICKENSON COMMUNITY HOSPITAL, INC
Other names
BHRHC Dickenson
Organization subpart
Yes
Provider details
NPI number
Legal business name
DICKENSON COMMUNITY HOSPITAL, INC
Authorized official
MARY LYNN KRUTAK (EVP/CFO)
(423) 302-3423
Entity
Organization
Contact information
Practice address
364 HOSPITAL DR, CLINTWOOD, VA 24228-6786
(276) 926-0200
(276) 926-6675
Mailing address
509 MED TECH PKWY STE 100, JOHNSON CITY, TN 37604-2579
(423) 302-6567
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101016773
VA
207Q00000X
Family Medicine Physician
0101240240
VA
207R00000X
Internal Medicine Physician
0102201380
VA
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
363L00000X
Nurse Practitioner
0017001384
VA
Other
Enumeration date
07/27/2006
Last updated
08/12/2024
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