Organization
RUSSELL COUNTY CLINIC CORP
Active
Other names
Lebanon Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MILLER (GROUP VP)
(286) 889-0201
Entity
Organization
Contact information
Practice address
640 OVERLOOK DRIVE, LEBANON, VA 24266
(276) 889-0201
(276) 889-0018
Mailing address
PO BOX 3600, LEBANON, VA 24266-0200
(276) 889-0201
(276) 889-0018
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
07/17/2006
Last updated
08/22/2020
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