Organization
24 ON PHYSICIANS. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN A. FULLER (SECRETARY)
(770) 740-0895
Entity
Organization
Contact information
Practice address
800 OAK STREET, FARMVILLE, VA 23901
(434) 315-2960
Mailing address
PO BOX 403631, ATLANTA, GA 30384-3631
(770) 740-0895
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/09/2006
Last updated
08/22/2020
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