Individual
WILLOUGHBY SHELTON HUNDLEY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
969 MADISON STREET, SUITE/BOX 297, BOYDTON, VA 23917
(434) 738-6911
(434) 738-0431
Mailing address
PO BOX 297, BOYDTON, VA 23917-0297
(434) 738-6911
(434) 738-0431
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101034527
VA
207P00000X
Emergency Medicine Physician
9801679
NC
207Q00000X
Family Medicine Physician
0101034527
VA
207Q00000X
Family Medicine Physician
9801679
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
265659
ANTHEM
VI
05
—
5644810
—
VA
Enumeration date
03/06/2006
Last updated
05/03/2024
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