Olimpo Fernando Fonseca (NPI# 1265443410, PAC ID# 9335168475) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1265443410 |
| PAC ID by PECOS | 9335168475 |
| Professional Enrollment ID | I20051117000310 |
| Full Name | Olimpo Fernando Fonseca |
| Organization Legal Name | CARILION TAZEWELL COMMUNITY HOSPITAL |
| Address |
388 Ben Bolt Ave Tazewell VA 24651-9700 |
| Phone Number | 2769888700 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF PUERTO RICO SCHOOL OF MEDICINE |
| Graduation Year | 1977 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | EMERGENCY MEDICINE |
| Group Practice PAC ID | 4183604259 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490117 | CARILION TAZEWELL COMMUNITY HOSPITAL |
| 490127 | BUCHANAN GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1535 Slate Creek Rd, Grundy, VA 24614-6974 | 2769351000 | UNITED EMERGENCY SERVICES INC. |
| 1906 Belleview Seave, Roanoke, VA 24014-1838 | 5409817000 | CARILION MEDICAL CENTER |
| 388 Ben Bolt Ave, Tazewell, VA 24651-9700 | 2769888700 | CARILION TAZEWELL COMMUNITY HOSPITAL |
| 388 Ben Bolt Ave, Tazewell, VA 24651-5386 | 2769888740 | CARILION MEDICAL CENTER |
| Organization Legal Name | CARILION TAZEWELL COMMUNITY HOSPITAL |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mannachanallur R Ramakrishnan | Diagnostic Radiology | Carilion Tazewell Community Hospital | 388 Ben Bolt Ave, Tazewell, VA 24651-9700 |
| Ronald L Washburn | Diagnostic Radiology | Carilion Tazewell Community Hospital | 388 Ben Bolt Ave, Tazewell, VA 24651-9700 |
| Vijay Ramakrishnan | Diagnostic Radiology | Carilion Tazewell Community Hospital | 388 Ben Bolt Ave, Tazewell, VA 24651-9700 |
| Qasim A Rao | Diagnostic Radiology | Carilion Tazewell Community Hospital | 388 Ben Bolt Ave, Tazewell, VA 24651-9700 |
| Michael D Rorrer | Emergency Medicine | Carilion Tazewell Community Hospital | 388 Ben Bolt Ave, Tazewell, VA 24651-9700 |
| Sher Z Khan | Internal Medicine | Carilion Tazewell Community Hospital | 388 Ben Bolt Ave, Tazewell, VA 24651-9700 |
| Street Address |
388 BEN BOLT AVE |
| City | TAZEWELL |
| State | VA |
| Zip | 24651-9700 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mannachanallur R Ramakrishnan | Diagnostic Radiology | Carilion Tazewell Community Hospital | 388 Ben Bolt Ave, Tazewell, VA 24651-9700 |
| Ronald L Washburn | Diagnostic Radiology | Carilion Tazewell Community Hospital | 388 Ben Bolt Ave, Tazewell, VA 24651-9700 |
| Vijay Ramakrishnan | Diagnostic Radiology | Carilion Tazewell Community Hospital | 388 Ben Bolt Ave, Tazewell, VA 24651-9700 |
| Qasim A Rao | Diagnostic Radiology | Carilion Tazewell Community Hospital | 388 Ben Bolt Ave, Tazewell, VA 24651-9700 |
| Samson Salazar Velena | Emergency Medicine | Carilion Medical Center | 388 Ben Bolt Ave, Tazewell, VA 24651-5386 |
| Michael D Rorrer | Emergency Medicine | Carilion Tazewell Community Hospital | 388 Ben Bolt Ave, Tazewell, VA 24651-9700 |
| Sher Z Khan | Internal Medicine | Carilion Tazewell Community Hospital | 388 Ben Bolt Ave, Tazewell, VA 24651-9700 |
| Tonia G Mitchell | Nurse Practitioner | Carilion Medical Center | 388 Ben Bolt Ave, Tazewell, VA 24651-5386 |
| La Donna B Osborne | Nurse Practitioner | Carilion Medical Center | 388 Ben Bolt Ave, Tazewell, VA 24651-5386 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tara R Prater | Clinical Social Worker | Southwest Virginia Community Health Systems Inc | 386 Ben Bolt Ave, Tazewell, VA 24651-5386 |
| Karen E Hart | Nurse Practitioner | 1632 Fincastle Tpke, Tazewell, VA 24651-6169 | |
| Pablo M Carpio | Internal Medicine | 1630 Fincastle Tpke, Tazewell, VA 24651-6169 | |
| Stephen Rinehart | Family Practice | Tazewell Family Physicans, PC | 123 Ben Bolt Ave, Tazewell, VA 24651-9703 |
| William Eric Shrader | Family Medicine | 986 Ben Bolt Ave, Tazewell, VA 24651-9706 |
| City | TAZEWELL |
| Zip Code | 24651 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | TAZEWELL + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Olimpo Fernando Fonseca.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.