| Clyburn Physician Services LLC | |
|
245 Medical Park Dr Marion VA 24354-1100 | |
| (276) 378-1000 | |
| Not Available |
| Full Name | Clyburn Physician Services LLC |
|---|---|
| Speciality | Hospitalist |
| Location | 245 Medical Park Dr, Marion, Virginia |
| Authorized Official Name and Position | Lisha C Falk (VICE PRESIDENT) |
| Authorized Official Contact | 3376091221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clyburn Physician Services LLC 200 Corporate Blvd Lafayette LA 70508-3870 Ph: (800) 893-9698 | Clyburn Physician Services LLC 245 Medical Park Dr Marion VA 24354-1100 Ph: (276) 378-1000 |
| NPI Number | 1740163179 |
|---|---|
| Provider Enumeration Date | 07/31/2025 |
| Last Update Date | 07/31/2025 |
| Certification Date | 07/31/2025 |
| Medicare PECOS PAC ID | 9335631100 |
|---|---|
| Medicare Enrollment ID | O20251120000320 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740163179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 208M00000X | Hospitalist | () | Primary |
| 363A00000X | Physician Assistant | () | Secondary |
| 363L00000X | Nurse Practitioner | () | Secondary |
| Provider Name | Nsekenene Kolongo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487685301 PECOS PAC ID: 0941277263 Enrollment ID: I20040915000436 |
| Provider Name | Jill K Couch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972561702 PECOS PAC ID: 6103878525 Enrollment ID: I20050214000956 |
| Provider Name | Syed I Shafqat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750345617 PECOS PAC ID: 1658313929 Enrollment ID: I20050608000865 |
| Provider Name | Jenny Marie Pruitt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528249133 PECOS PAC ID: 3173606365 Enrollment ID: I20080211000842 |
| Provider Name | Olusegun John |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174796130 PECOS PAC ID: 2062578164 Enrollment ID: I20090715000576 |
| Provider Name | Rhonel Lanique Citterbart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962797092 PECOS PAC ID: 7214106236 Enrollment ID: I20110809000396 |
| Provider Name | Brian K Stiltner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356638076 PECOS PAC ID: 6507083912 Enrollment ID: I20140808000467 |
| Provider Name | Holly Hieb |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831483973 PECOS PAC ID: 1759504327 Enrollment ID: I20140905000395 |
| Provider Name | Michael Eugene Sutherland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639442213 PECOS PAC ID: 7214988450 Enrollment ID: I20190909003642 |
| Provider Name | Nathan Adam Varbanoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134678667 PECOS PAC ID: 6406135714 Enrollment ID: I20191028001446 |
| Provider Name | Laddie M Crisp |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184114175 PECOS PAC ID: 4789932203 Enrollment ID: I20211022000384 |
| Provider Name | Mohammad Khan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659891109 PECOS PAC ID: 3476824160 Enrollment ID: I20211124001756 |
| Provider Name | Olatunji S Olaoye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962668970 PECOS PAC ID: 2961690839 Enrollment ID: I20220111002331 |
| Provider Name | Munsif Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881973147 PECOS PAC ID: 2668628371 Enrollment ID: I20221004001962 |
| Provider Name | Jamil Meloelain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538262076 PECOS PAC ID: 0749206977 Enrollment ID: I20221222001497 |
| Provider Name | Emily R Felzenberg |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1063684702 PECOS PAC ID: 5890872329 Enrollment ID: I20230426002019 |
| Provider Name | Fnu Warsha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205445079 PECOS PAC ID: 0345602967 Enrollment ID: I20230815000647 |
| Provider Name | Sana Perveen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679853618 PECOS PAC ID: 0143445288 Enrollment ID: I20240508000441 |
| Provider Name | Mohamed Gharib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720575137 PECOS PAC ID: 7012319387 Enrollment ID: I20240827001396 |
| Provider Name | Syed Muhammad Tayyab |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780952994 PECOS PAC ID: 0345468815 Enrollment ID: I20250102002844 |
| Provider Name | Matthew Sgouros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215673090 PECOS PAC ID: 8628554607 Enrollment ID: I20260108004086 |
Msmg Im Mar Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1118 Snider St, Marion, VA 24354 Phone: 276-783-5148 Fax: 276-783-6716 |
Ballad Health Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 Brunswick Ln, Marion, VA 24354 Phone: 276-783-9687 Fax: 276-783-1310 |
Marion Mat Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 416 E Main St Rm 2, Marion, VA 24354 Phone: 276-783-8185 |
Py Medical Services of TN PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Francis Marion Ln, Marion, VA 24354 Phone: 276-378-1800 |
The Garzon Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1122 Culbert Drive, Marion, VA 24354 Phone: 276-783-7913 Fax: 276-783-1882 |
Dave Parker Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1224 Greer Ave, Marion, VA 24354 Phone: 276-920-7242 |