Provider Demographics
NPI:1447501473
Name:APPALACHIAN PSYCHIATRY
Entity type:Organization
Organization Name:APPALACHIAN PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:OLMSTED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-628-4926
Mailing Address - Street 1:120 COURT ST SE
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-3300
Mailing Address - Country:US
Mailing Address - Phone:276-628-4926
Mailing Address - Fax:276-628-4936
Practice Address - Street 1:120 COURT ST SE
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-3300
Practice Address - Country:US
Practice Address - Phone:276-628-4926
Practice Address - Fax:276-628-4936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012372002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty