# COMMONWEALTH FAMILY PHYSICIANS, INC.

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

## Provider details

- **NPI number:** 1972616431
- **Authorized official:** DR. MYRON EDWARD ELLER JR. M.D. (CEO/PRESIDENT)
- **Authorized official phone:** (276) 632-3841

## Contact information

- **Practice address:** 445 COMMONWEALTH BLVD E, MARTINSVILLE, VA 24112-2014
- **Practice address phone:** (276) 632-3841
- **Practice address fax:** (276) 632-2437
- **Mailing address:** 445 COMMONWEALTH BLVD E, MARTINSVILLE, VA 24112-2014
- **Mailing address phone:** (276) 632-3841
- **Mailing address fax:** (276) 632-2437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/17/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 466796 | ANTHEM GROUP NUMBER | VA |
| 01 | — | CB1505 | RAILROAD MEDICARE GROUP \# | VA |