Marshal Thomas Gwynn (NPI# 1407173982, PAC ID# 8224270038) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.
| Nation Provider ID (NPI) | 1407173982 |
| PAC ID by PECOS | 8224270038 |
| Professional Enrollment ID | I20130807000591 |
| Full Name | Marshal Thomas Gwynn |
| Organization Legal Name | FOOT AND ANKLE CLINIC OF THE VIRGINIAS INC |
| Address |
3706 S Main St Blacksburg VA 24060-7006 |
| Phone Number | 54095133387006 |
| Gender | M |
| Medical School | OHIO COLLEGE OF PODIATRIC MEDICINE |
| Graduation Year | 2010 |
| Primary Specialty | PODIATRY |
| Group Practice PAC ID | 7911948583 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 510046 | PRINCETON COMMUNITY HOSPITAL |
| 510071 | BLUEFIELD REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3706 S Main St, Blacksburg, VA 24060-7006 | 54095133387006 | FOOT AND ANKLE CLINIC OF THE VIRGINIAS INC |
| 2036 Leatherwood Ln, Bluefield, VA 24605-2020 | 2763221800 | FOOT AND ANKLE CLINIC OF THE VIRGINIAS INC |
| 5504 Maccorkle Ave Se, Charleston, WV 25304-2320 | 8002559255 | FOOT AND ANKLE CLINIC OF THE VIRGINIAS INC |
| 401 Rogers St, Princeton, WV 24740-3636 | 3044879442 | FOOT AND ANKLE CLINIC OF THE VIRGINIAS INC |
| Organization Legal Name | FOOT AND ANKLE CLINIC OF THE VIRGINIAS INC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bradley Henry Hoffman | Podiatry | Foot and Ankle Clinic of The Virginias Inc | 401 Rogers St, Princeton, WV 24740-3636 |
| Robert Schopf | Podiatry | Foot and Ankle Clinic of The Virginias Inc | 2036 Leatherwood Ln, Bluefield, VA 24605-2020 |
| Mark T Wilt | Podiatry | Foot and Ankle Clinic of The Virginias Inc | 3706 S Main St, Blacksburg, VA 24060-7006 |
| Joseph G Protain | Vascular Surgery | Foot and Ankle Clinic of The Virginias Inc | 813 Kentwood Dr, Youngstown, OH 44512-5004 |
| Jeremy Brouillette | Podiatry | Foot and Ankle Clinic of The Virginias Inc | 401 Rogers St, Princeton, WV 24740-3636 |
| Douglas Stewart Dockery | Podiatry | Foot and Ankle Clinic of The Virginias Inc | 3706 S Main St, Blacksburg, VA 24060-7006 |
| James Louis Chianese | Podiatry | Foot and Ankle Clinic of The Virginias Inc | 401 Rogers St, Princeton, WV 24740-3636 |
| Timothy J Donatelli | Podiatry | Foot and Ankle Clinic of The Virginias Inc | 401 Rogers St, Princeton, WV 24740-3636 |
| Luciano L Serdoz | Podiatry | Foot and Ankle Clinic of The Virginias Inc | 401 Rogers St, Princeton, WV 24740-3636 |
| Street Address |
3706 S MAIN ST |
| City | BLACKSBURG |
| State | VA |
| Zip | 24060-7006 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark T Wilt | Podiatry | Foot and Ankle Clinic of The Virginias Inc | 3706 S Main St, Blacksburg, VA 24060-7006 |
| Melanie A Schano | Nurse Practitioner | Valley Skin Specialists | 3706 S Main St, Suite B, Blacksburg, VA 24060-7006 |
| Eric C Parlette | Dermatology | Valley Skin Specialists | 3706 S Main St, Suite B, Blacksburg, VA 24060-7006 |
| Jeremy S Morgan | Physician Assistant | Valley Skin Specialists | 3706 S Main St, Suite B, Blacksburg, VA 24060-7006 |
| Douglas Stewart Dockery | Podiatry | Foot and Ankle Clinic of The Virginias Inc | 3706 S Main St, Blacksburg, VA 24060-7006 |
| Jason E Bailey | Physician Assistant | Valley Skin Specialists | 3706 S Main St, Suite B, Blacksburg, VA 24060-7006 |
| Chad Johnston | Dermatology | Valley Skin Specialists | 3706 S Main St, Suite B, Blacksburg, VA 24060-7006 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gwendolyn W Spangler | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Kristopher Joel Hansen | Hematology/oncology | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Michele Lee Keesling | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Charlene M Jordan | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Amy Ratcliffe Butler | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Heather L Bayless | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Mazen I Madhoun | Family Medicine | 3400 Southpoint Dr, Blacksburg, VA 24060-1261 | |
| Glenda Beekmann Ball | Nurse Practitioner | Family Medicine of Blacksburg, LLC | 1645 N Main St, Blacksburg, VA 24060-2554 |
| Avery M Matthews | Psychiatry | Family Medicine of Blacksburg, LLC | 1645 N Main St, Blacksburg, VA 24060-2554 |
| Lynn M Bever | Psychologist, Clinical | 1501 Lark Ln, Blacksburg, VA 24060-2658 | |
| Find all physicians in zip 24060 | |||
| City | BLACKSBURG |
| Zip Code | 24060 |
| Specialty | PODIATRY |
| City + Specialty | BLACKSBURG + PODIATRY |
Please comment or provide details below to improve the information on Marshal Thomas Gwynn.
| 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.