| Organization Name: | CENTRA MEDICAL GROUP SOUTHSIDE, LLC |
| NPI Number: | 1174864615 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM BASS (VP COO) |
| Mailing Address: | 800 Oak St Farmville |
| State: | VA US |
| Postal Code: | 239011199 |
| Phone Number: | 4343152530 |
| Fax Number: | |
| NPI Enumeration Date: | 03/08/2013 |
| NPI Last Update Date: | 03/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207P00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Emergency Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |