Organization
CENTRA MEDICAL GROUP, LLC
Active
Parent organization
CENTRA MEDICAL GROUP, LLC
Other names
CMG Critical Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRA MEDICAL GROUP, LLC
Authorized official
JOSHUA LARKIN (PAYER CREDENTIALING MANAGER)
(434) 200-5047
Entity
Organization
Contact information
Practice address
1901 TATE SPRINGS RD, LYNCHBURG, VA 24501-1109
(434) 200-2925
Mailing address
1937 THOMSON DR, LYNCHBURG, VA 24501-1008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/10/2018
Last updated
05/10/2018
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