| Ainsley Medical Llc | |
|
1108 Main St Danville VA 24541-2940 | |
| (434) 421-6180 | |
| (434) 421-4974 |
| Full Name | Ainsley Medical Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1108 Main St, Danville, Virginia |
| Authorized Official Name and Position | Mark Ainsley Innis (PHYSICIAN) |
| Authorized Official Contact | 4344216180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ainsley Medical Llc 1108 Main St Danville VA 24541-2940 Ph: (434) 421-6180 | Ainsley Medical Llc 1108 Main St Danville VA 24541-2940 Ph: (434) 421-6180 |
| NPI Number | 1265124689 |
|---|---|
| Provider Enumeration Date | 05/24/2023 |
| Last Update Date | 07/05/2023 |
| Medicare PECOS PAC ID | 6204280597 |
|---|---|
| Medicare Enrollment ID | O20230920001427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265124689 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Secondary |
| 261QE0002X | Clinic/center - Emergency Care | (* (Not Available)) | Primary |
| Provider Name | Mark A Innis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740450220 PECOS PAC ID: 6800969601 Enrollment ID: I20080725000496 |
| Provider Name | Viola L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912369489 PECOS PAC ID: 0941588545 Enrollment ID: I20161102002119 |
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