Kimberly A Mizack in Salem - Physician Assistant
Kimberly A Mizack - NPI 1639251762
Kimberly A Mizack is a Physician Assistant in Salem, Virginia. Kimberly A Mizack practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Kimberly A Mizack is 1639251762. The last update date is 2022-02-10.
Kimberly A Mizack's current location address is 1802 Braeburn Dr, Salem, Virginia. You can contact this provider via phone number 5407723530 and fax number 5407762036. The mailing address for Kimberly A Mizack is 1802 Braeburn Dr, Salem, Virginia. To know further, please read the information below!
Provider Profile Detail
Provider Name | Kimberly A Mizack |
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Address | 1802 Braeburn Dr, Salem, Virginia |
Phone Number | 5407723530 |
Fax Number | 5407762036 |
Sole Proprietor | N |
Credentials | P.A. |
NPI Number Detail
NPI Number | 1639251762 |
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Provider Enumeration Date | 2006-10-19 |
Last Updated Date | 2022-02-10 |
Provider Mailing Address Detail
Address | 1802 Braeburn Dr |
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City | Salem |
State | Virginia (VA) |
Post Code | 241537357 |
Phone Number | 5407723530 |
Fax Number | 5407762036 |
Provider's Primary Taxonomy Detail
Speciality | Physician Assistant |
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Taxonomy | 363A00000X |
Licence No | 110002410 |
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
1639251762 | VA | BLACK LUNG | |
1639251762 | VA | INTOTAL | |
540506332108 | VA | TRICARE | |
1639251762 | VA | OPTIMA HEALTH PLAN | |
1639251762 | VA | MEDICAID QMB | |
P01535314 | VA | RAILROAD MEDICARE | |
1639251761 | VA | AETNA | |
1639251762 | VA | SOUTHERN HEALTH/CARENET/CARELI | |
1639251762 | VA | HUMANA MEDICARE | |
P00803340 | VA | RAILROAD MEDICARE |
Post Comment/ Review Below
What is the unique provider identifier assigned to Kimberly A Mizack?
The Kimberly A Mizack has been issued the NPI (National Provider Identifier) 1639251762 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
What is Kimberly A Mizack's area of expertise and its corresponding taxonomy classification?
The Kimberly A Mizack's field of specialization is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their areas of practice.
When did Kimberly A Mizack receive its 1639251762 assignment?
The Kimberly A Mizack was assigned its 1639251762 on 2006-10-19, which is the date when this unique identifier was issued to the organization.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1639251762 to Kimberly A Mizack?
The Centers for Medicare & Medicaid Services originally issued the 1639251762 to Kimberly A Mizack on 2006-10-19.
When was the information regarding Kimberly A Mizack, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Kimberly A Mizack, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2022-02-10.