Basic Information
| Provider Information | |||||||||
| NPI: | 1558575951 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | B & B MEDICAL PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 280 VA AVE NE | ||||||||
| Address2: | STE 102 | ||||||||
| City: | NORTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 24273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766790818 | ||||||||
| FaxNumber: | 2766799128 | ||||||||
| Practice Location | |||||||||
| Address1: | 280 VA AVE NE | ||||||||
| Address2: | STE 102 | ||||||||
| City: | NORTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 24273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766790818 | ||||||||
| FaxNumber: | 2766799128 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2007 | ||||||||
| LastUpdateDate: | 01/14/2008 | ||||||||
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| AuthorizedOfficialLastName: | BANCHUIN | ||||||||
| AuthorizedOfficialFirstName: | THONGDANG | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2766790818 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 0101029458 | VA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice | 208600000X | 0101029458 | VA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.