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
Address 1802 Braeburn Dr, Salem, Virginia
Phone Number 5407723530
Fax Number 5407762036
Sole Proprietor N
Credentials P.A.

NPI Number Detail

NPI Number 1639251762
Provider Enumeration Date 2006-10-19
Last Updated Date 2022-02-10

Provider Mailing Address Detail

Address 1802 Braeburn Dr
City Salem
State Virginia (VA)
Post Code 241537357
Phone Number 5407723530
Fax Number 5407762036

Provider's Primary Taxonomy Detail

Speciality Physician Assistant
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

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FAQs about Kimberly A Mizack

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.

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