Ketchersid, Terry L
Ketchersid, Terry L is an individual health care provider with primary practice located at 2232 Wilborn Ave , South Boston VA 24592. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ketchersid, Terry L can be contacted via phone (434) 517-3914.Contact Information
Primary practice address
2232 Wilborn Ave
South Boston VA 24592
Phone: (434) 517-3914
Fax: (434) 517-3912
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 0101054573 | Virginia |
Profile Details
| NPI number | 1609881192 |
|---|---|
| LBN Legal business name | Ketchersid, Terry L |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1609881192 | NPPES |
| Virginia | Other | 188149 | ANTHEM |
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