Laurel Fork Family Practice

NPI #1336639657 in Laurel Fork, Virginia

Provider Information

NPI Number: 1336639657
Entity Type: Organization
Organization Name: Laurel Fork Family Practice
Primary Specialty: Family Medicine
Enumeration Date: May 11, 2018
Last Updated: May 11, 2018

Practice Location

Address: 1205 STONE MOUNTAIN ROAD
City: Laurel Fork
State: Virginia
ZIP Code: 24352
Phone: (276) 398-2532

Authorized Official

Name: DR. JOHN WILLIAM TRACY, MD
Title: OWNER
Phone: (276) 398-2532

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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