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Organization

KENNETH E ANSELMI MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KENNETH E ANSELMI MD (OWNER)
(276) 963-0895
Entity
Organization

Contact information

Practice address
5433 GOVERNOR G C PEERY HWY, DORAN, VA 24612
(276) 963-0895
(276) 963-5712
Mailing address
PO BOX 263, DORAN, VA 24612
(276) 963-0895
(276) 963-5712

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6371108
VA
Enumeration date
05/18/2007
Last updated
08/22/2020
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