Provider Demographics
NPI:1154401636
Name:MOUNTAIN VIEW FAMILY MEDICINE PLC
Entity type:Organization
Organization Name:MOUNTAIN VIEW FAMILY MEDICINE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOLTHUS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:540-465-8051
Mailing Address - Street 1:33674 OLD VALLEY PIKE
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22657-3704
Mailing Address - Country:US
Mailing Address - Phone:540-465-8051
Mailing Address - Fax:540-465-5008
Practice Address - Street 1:33674 OLD VALLEY PIKE
Practice Address - Street 2:
Practice Address - City:STRASBURG
Practice Address - State:VA
Practice Address - Zip Code:22657-3704
Practice Address - Country:US
Practice Address - Phone:540-465-8051
Practice Address - Fax:540-465-5008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADB7886OtherMCARE PTAN
VA005617359Medicaid
VA005617359Medicaid