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Organization

KENBRIDGE FAMILY MEDICINE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRAHAM H. POWERS III MD (PRESIDENT)
(434) 676-8021
Entity
Organization

Contact information

Practice address
306 E 6TH AVE, KENBRIDGE, VA 23944-2050
(434) 676-8021
(434) 676-2390
Mailing address
306 E 6TH AVE, KENBRIDGE, VA 23944-2050
(434) 676-8021
(434) 676-2390

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5903037
NC MEDICAID #
VA
01
CE7948
RR MEDICARE
VA
Enumeration date
05/22/2006
Last updated
03/25/2013
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