Organization
SOUTHSIDE PULMONARY AND INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUZANNE B KAISER M.D. (PRESIDENT CORP.)
(434) 447-3899
Entity
Organization
Contact information
Practice address
202 E FERRELL ST, SOUTH HILL, VA 23970-2104
(434) 447-3899
(434) 447-7120
Mailing address
PO BOX 155, 202 E. FERRELL ST., SOUTH HILL, VA 23970
(434) 447-3899
(434) 447-7120
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101046990
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
086255
ANTHEM
VA
05
—
6007597
—
VA
Enumeration date
03/06/2009
Last updated
06/22/2010
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