Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dickenson Medical Associates a Department of Dickenson Community Hospi

Organization Family Medicine Physician · NPI 1871517151

Dickenson Medical Associates a Department of Dickenson Community Hospi is a Family Medicine Physician in Clintwood, Virginia. Licensed in Virginia. Registered with an NPI since 2006.

Licensed in
VA
In the registry since
2006
Specialties on file
5

Practice location Address checks out

364 Hospital Dr
Clintwood, VA 24228-6786
Phone: (276) 926-0200
Fax: (276) 926-6675
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rural Health Clinic/Center (primary) Taxonomy 261QR1300X
Family Medicine Physician Taxonomy 207Q00000X · Licence 0101240240 (VA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 0101016773 (VA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 0102201380 (VA)
Nurse Practitioner Taxonomy 363L00000X · Licence 0017001384 (VA)

Record details

NPI number1871517151
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationDickenson Community Hospital, Inc
Authorized official Mary Krutak — Evp/Cfo · (423) 302-3423
Other names Bhrhc Dickenson
NPI enumeratedJuly 27, 2006
Last updated in NPPESAugust 12, 2024
Certification dateAugust 12, 2024
Mailing address509 Med Tech Pkwy Ste 100, Johnson City, TN 37604-2579

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