Organization
DOMINION HEALTH MEDICAL ASSOC
Active
Other names
Sentara Chase City Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
CECIL F HAZELWOOD (MANAGER (SDHG))
(434) 517-3515
Entity
Organization
Contact information
Practice address
946 N. MAIN ST, CHASE CITY, VA 23924
(434) 372-5141
(434) 517-3887
Mailing address
P.O. BOX 860, SOUTH BOSTON, VA 24592
(434) 517-3513
(434) 517-3887
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
0101032102
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007610114
—
VA
Enumeration date
09/20/2006
Last updated
02/11/2015
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