Bumgardner, Jack H
Bumgardner, Jack H is an individual health care provider with primary practice located at 195 Maple Ave , Rocky Mount VA 24151-1506. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bumgardner, Jack H can be contacted via phone (540) 483-5168.Contact Information
Primary practice address
195 Maple Ave
Rocky Mount VA 24151-1506
Phone: (540) 483-5168
Fax: (540) 483-5835
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0101-021970 | Virginia |
Profile Details
| NPI number | 1659351856 |
|---|---|
| LBN Legal business name | Bumgardner, Jack H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 23rd, 2006 |
| Last updated | Mar 28th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659351856 | NPPES |
| Virginia | MEDICAID | 005623669 |
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