Organization
MOUNTAIN VIEW EAR NOSE AND THROAT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY DAWN KERNS (OFFICE MANAGER)
(540) 542-1995
Entity
Organization
Contact information
Practice address
112 MEDICAL CIR, WINCHESTER, VA 22601-3322
(540) 542-1995
(540) 542-1996
Mailing address
112 MEDICAL CIR, WINCHESTER, VA 22601-3322
(540) 542-1995
(540) 542-1996
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101034967
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006503586
—
VA
01
—
013390M89
MEDICARE ID
—
05
—
1306873906
—
WV
Enumeration date
07/18/2006
Last updated
03/10/2011
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