Individual
DR. DAVID H. MORTLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4910 VALLEY VIEW BLVD NW, ROANOKE, VA 24012-2040
(540) 265-1607
(540) 366-7353
Mailing address
4910 VALLEY VIEW BLVD NW, ROANOKE, VA 24012-2040
(540) 265-1607
(540) 366-7353
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
116019067
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861691552
—
VA
Enumeration date
07/13/2007
Last updated
09/14/2010
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