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SOUTHSIDE MEDICAL ASSOCIATES P.C NPI 1760589287


NPI Information

NPI: 1760589287
Provider Name: SOUTHSIDE MEDICAL ASSOCIATES P.C
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
2202-A BEECHMONT ROAD
SOUTH BOSTON, VA
ZIP 24592
Phone: (434) 575-6300
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SOUTHSIDE MEDICAL ASSOCIATES P.C is an internal medicine in South Boston, VA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. SOUTHSIDE MEDICAL ASSOCIATES P.C NPI is 1760589287. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2202-A BEECHMONT ROAD
SOUTH BOSTON, VA
ZIP 24592-547
Phone: (434) 575-6300
Fax: (434) 575-8300

The provider's authorized official is Sherry Lene Hall .
The authorized official title is M.d and has the following contact phone number (434) 575-6300.

The enumeration date for this NPI number is 9/19/2006 and was last updated on 7/14/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine010141405VIRGINIANo
2207R00000XInternal Medicine0101023654VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1110244239OTHERVIRGINIARR MEDICARE
2B08512MEDICARE UPIN
3110244240OTHERVIRGINIARR MEDICARE
420602OTHEROPTIMA
5005880769MEDICAIDVIRGINIA
644111OTHEROPTIMA
7C08477MEDICARE UPIN
800V009577MEDICARE ID-TYPE UNSPECIFIEDVIRGINIA
9D27012MEDICARE UPIN
1000V010577MEDICARE ID-TYPE UNSPECIFIEDVIRGINIA
11005880777MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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