DR. AGUSTIN V VITUALLA (NPI# 1134217029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134217029 |
| Entity Type | Individual |
| Full Name | DR. AGUSTIN V VITUALLA |
| Credential | MD |
| Practice Address |
135 Hospital Dr Camden TN 38320 |
| Mailing Address |
Po Box 625 135 Hospital Dr Camden TN 38320 |
| Practice Telephone | 7315842117 |
| Practice Fax Number | 7315843564 |
| Mailing Telephone | 7315842117 |
| Mailing Fax Number | 7315843564 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2011-10-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 017177 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3021196 | 05 |
| Street Address |
135 HOSPITAL DR |
| City | CAMDEN |
| State | TN |
| Zip Code | 38320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144525395 | Mickie Carter | Physician Assistant | 284 Hwy 641 N, Camden, TN 38320 | 2011-01-19 |
| 1447574249 | Virginia Margarita Peebles | Nurse Practitioner | 176 Briarwood Ave, Suite B, Camden, TN 38320 | 2010-03-23 |
| 1194857417 | Tron D Baker | Case Manager/Care Coordinator | 495 Liberty Rod, Camden, TN 38320 | 2007-03-12 |
| 1801968854 | Michael Eugene Bogard | Physical Therapist | 77 East Lake St, Camden, TN 38320 | 2006-11-14 |
| 1629000567 | Freds Stores of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 195 North 641, Camden, TN 38320 | 2006-07-07 |
| 1215995287 | Quality Home Health Care, Inc. | Home Health | 279 W Main St, Camden, TN 38320 | 2006-05-01 |
| 1285612564 | Camden Medical Clinic, Inc | Clinic/Center | 160 Hospital Dr., Camden, TN 38320 | 2006-01-06 |
| 1073513636 | William Hall Mcconnell | Optometrist | 194 W. Main St., Camden, TN 38320 | 2005-07-26 |
| 1790077139 | Ccc Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 115 Vicksburg Ave, Camden, TN 38320 | 2011-05-04 |
| 1730240441 | State of Tennessee | Public Health or Welfare | 225 Hospital Drive, Camden, TN 38320 | 2006-12-13 |
| Find all providers in zip 38320 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1609088905 | Sprain and Strain Center, PC | General Practice | 1014 Broadway, Camden, NJ 08103 | 2007-05-07 |
| 1831511146 | Agape Family Wellness Clinic | General Practice | 101 Hospital Dr, Camden, TN 38320-1617 | 2014-01-07 |
| 1932119138 | Rufus Lester Neville Jr. | General Practice | 1007 Church St, Camden, SC 29020-4211 | 2006-08-09 |
| 1174513303 | Robert I Bourne Jr. | General Practice | 101 Hospital Dr, Camden, TN 38320-1617 | 2005-10-27 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.