Individual
DR. SAMUEL D VERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1070 TERRACE DR, MARION, VA 24354-4138
(276) 781-2225
(276) 783-8843
Mailing address
1070 TERRACE DR, MARION, VA 24354-4138
(276) 781-2225
(276) 783-8843
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101025422
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0385921
UNITED MINE WORKERS
VA
05
—
1285631796
—
VA
01
—
144631
ANTHEM
VA
01
—
202760
BLACK LUNG
VA
01
—
P00197424
RAILROAD MEDICARE
VA
Enumeration date
06/30/2005
Last updated
02/21/2013
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