Organization
PIONEER HEALTH SERVICES OF PATRICK COUNTY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH S MCNULTY III (CEO)
(601) 849-6440
Entity
Organization
Contact information
Practice address
18688 JEB STUART HWY, STUART, VA 24171-1559
(276) 694-8600
(276) 694-8679
Mailing address
301 8TH AVE SW, MAGEE, MS 39111-3967
(601) 849-6440
(601) 849-6443
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
H1919
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982858585
—
VA
01
—
362626
BCBS ER
VA
Enumeration date
04/10/2009
Last updated
04/10/2009
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