Organization
COMMONWEALTH GENERAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK L FOREST MD (OWNER)
(434) 447-3404
Entity
Organization
Contact information
Practice address
901 PACE DR, SOUTH HILL, VA 23970-1307
(434) 447-3404
Mailing address
PO BOX 215, SOUTH HILL, VA 23970-0215
(434) 447-3404
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0102049972
VA
Other
Enumeration date
10/03/2006
Last updated
08/22/2020
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