| Southside Medical Associates P.c | |
|
2202-a Beechmont Road South Boston VA 24592-2547 | |
| (434) 575-6300 | |
| (434) 575-8300 |
| Full Name | Southside Medical Associates P.c |
|---|---|
| Speciality | Internal Medicine |
| Location | 2202-a Beechmont Road, South Boston, Virginia |
| Authorized Official Name and Position | Sherry Lene Hall (M.D) |
| Authorized Official Contact | 4345756300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Medical Associates P.c 2202-a Beechmont Road South Boston VA 24592-2547 Ph: (434) 575-6300 | Southside Medical Associates P.c 2202-a Beechmont Road South Boston VA 24592-2547 Ph: (434) 575-6300 |
| NPI Number | 1760589287 |
|---|---|
| Provider Enumeration Date | 09/19/2006 |
| Last Update Date | 07/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760589287 | NPI | - | NPPES |
| 110244240 | Other | VA | RR MEDICARE |
| 005880777 | Medicaid | VA | |
| 005880769 | Medicaid | VA | |
| 110244239 | Other | VA | RR MEDICARE |
| 44111 | Other | OPTIMA | |
| 20602 | Other | OPTIMA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101023654 (Virginia) | Primary |
| 207R00000X | Internal Medicine | 010141405 (Virginia) | Secondary |
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