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CLAIBORNE GOOCH WHITWORTH IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 SPOTSWOOD DR, LEXINGTON, VA 24450-2454
(540) 463-7108
(540) 462-2923
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5715

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101049835
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010080576
VA
01
137919
ANTHEM/BLUE CROSS
01
54-0892025
TAX ID
Enumeration date
01/11/2006
Last updated
08/09/2022
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