Organization
MARK T MAHONEY DO PC
Active
Other names
MAHONEY FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK THOMAS MAHONEY DO (OWNER)
(276) 666-0500
Entity
Organization
Contact information
Practice address
445 COMMONWEALTH BLVD E, SUITE A, MARTINSVILLE, VA 24112-2086
(276) 666-0500
(276) 666-0400
Mailing address
PO BOX 5544, MARTINSVILLE, VA 24115-5544
(276) 666-0500
(276) 666-0400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102201617
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49D1032709
CLIA
VA
Enumeration date
03/19/2014
Last updated
03/19/2014
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