Organization
DOMINION HEALTH MEDICAL ASSOC.
Active
Other names
Sentora Halifax General Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
CECIL HAZELWOOD (MANAGER (SDHG))
(434) 517-3590
Entity
Organization
Contact information
Practice address
2212 WILBORN AVE, SOUTH BOSTON, VA 24592
(434) 517-3529
(434) 517-3887
Mailing address
P.O. BOX 860, SOUTH BOSTON, VA 24592
(434) 517-3513
(434) 517-3887
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/28/2013
Last updated
02/10/2015
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