Individual
DR. JOHN S MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
109 BRIDGE STREET SUITE 300, DANVILLE, VA 24541-1222
(434) 793-4711
(434) 797-2514
Mailing address
109 BRIDGE STREET SUITE 300, DANVILLE, VA 24541-1222
(434) 793-4711
(434) 797-2514
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101042392
VA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
0101042392
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
065845
BC VA
VA
05
—
1578544912
—
VA
05
—
5901472
—
NC
Enumeration date
11/11/2005
Last updated
06/10/2020
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