| The Doctors Office Llc | |
|
609 E Main St Abingdon VA 24210-2339 | |
| (276) 525-8144 | |
| (276) 258-5326 |
| Full Name | The Doctors Office Llc |
|---|---|
| Speciality | Counselor |
| Location | 609 E Main St, Abingdon, Virginia |
| Authorized Official Name and Position | Lester Ford (OWNER) |
| Authorized Official Contact | 2765258144 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Doctors Office Llc 609 E Main St Abingdon VA 24210-2339 Ph: (276) 525-8144 | The Doctors Office Llc 609 E Main St Abingdon VA 24210-2339 Ph: (276) 525-8144 |
| NPI Number | 1063047819 |
|---|---|
| Provider Enumeration Date | 03/11/2020 |
| Last Update Date | 09/01/2021 |
| Certification Date | 09/01/2021 |
| Medicare PECOS PAC ID | 0648676148 |
|---|---|
| Medicare Enrollment ID | O20210909000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063047819 | NPI | - | NPPES |
| 1558562850 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Pyung Jay Suh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295779148 PECOS PAC ID: 2860478922 Enrollment ID: I20040629000045 |
| Provider Name | Michael A Cockrum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447470067 PECOS PAC ID: 4587638242 Enrollment ID: I20041020001099 |
| Provider Name | Tony E Yost |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003858796 PECOS PAC ID: 6608789938 Enrollment ID: I20060314000591 |
| Provider Name | Andrew N Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558562850 PECOS PAC ID: 8729189881 Enrollment ID: I20070719000774 |
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