Individual provider · Type 1 NPI
Agustin V. Vitualla, MD
General Practice Physician · Camden, TN
NPI number
1134217029
Active
Practice location
135 Hospital Dr
Camden, TN 38320
Fax (731) 584-3564
Mailing address
PO Box 625, 135 Hospital Dr
Camden, TN 38320
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | 017177 (TN) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
About NPI 1134217029
Agustin V. Vitualla, MD's National Provider Identifier is 1134217029, issued on Oct 10, 2006. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Camden, TN. The record was last updated on Oct 20, 2011.