Organization
CENTRA MEDICAL GROUP, LLC
Active
Organization
CENTRA MEDICAL GROUP, LLC
Active
Parent organization
CENTRA MEDICAL GROUP, LLC
Other names
CMG Vascular Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRA MEDICAL GROUP, LLC
Authorized official
JOSHUA LARKIN (PAYER CREDENTIALING MANAGER)
(434) 200-5047
Entity
Organization
Contact information
Practice address
2410 ATHERHOLT RD, LYNCHBURG, VA 24501-2148
(434) 200-5047
Mailing address
1937 THOMSON DR, LYNCHBURG, VA 24501-1008
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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