Centra Medical Group, LLC

NPI #1295104347 in Bedford, Virginia

Provider Information

NPI Number: 1295104347
Entity Type: Organization
Organization Name: Centra Medical Group, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: CENTRA MEDICAL GROUP, LLC
Primary Specialty: Family Medicine
Enumeration Date: Sep 18, 2015
Last Updated: Sep 18, 2015

Practice Location

Address: 1613 OAKWOOD ST
Address 2: SUITE 201
City: Bedford
State: Virginia
ZIP Code: 24523-1213
Phone: (540) 586-7273

Authorized Official

Name: JOSEPH KOONS
Title: MANAGING DIRECTOR
Phone: (434) 200-5047

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Family Medicine	207Q00000X	Primary

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