Organization
WYTHE GASTROENTERLOGY
Active
Organization
WYTHE GASTROENTERLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH TAYLOR MD (PRESIDENT)
(276) 228-2383
Entity
Organization
Contact information
Practice address
590 W RIDGE RD, SUITE E, WYTHEVILLE, VA 24382-1094
(276) 228-2383
(276) 228-5829
Mailing address
590 W RIDGE RD, SUITE E, WYTHEVILLE, VA 24382-1094
(276) 228-2383
(276) 228-5829
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
248472
BCBS OF VA
VA
01
—
C09998
MEDICARE GROUP #
VA
01
—
DF4627
RAILROAD MEDICARE GROUP
VA
Enumeration date
10/25/2006
Last updated
09/07/2010
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