Basic Information
| Provider Information | |||||||||
| NPI: | 1366487589 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PATIENT CHOICE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 55 COMFORT WAY | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 244503788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404633381 | ||||||||
| FaxNumber: | 5404633477 | ||||||||
| Practice Location | |||||||||
| Address1: | 55 COMFORT WAY | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 244503788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404633381 | ||||||||
| FaxNumber: | 5404633477 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2006 | ||||||||
| LastUpdateDate: | 05/12/2008 | ||||||||
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| AuthorizedOfficialLastName: | KERSCHL | ||||||||
| AuthorizedOfficialFirstName: | WALTER | ||||||||
| AuthorizedOfficialMiddleName: | CHARLES | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5404633381 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.