Dr Agustin V Vitualla, MD | |
135 Hospital Dr, Camden, TN 38320 | |
(731) 584-2117 | |
(731) 584-3564 |
Full Name | Dr Agustin V Vitualla |
---|---|
Gender | Male |
Speciality | General Practice |
Location | 135 Hospital Dr, Camden, Tennessee |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134217029 | NPI | - | NPPES |
3021196 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 017177 (Tennessee) | Primary |
Mailing Address | Practice Location Address |
---|---|
Dr Agustin V Vitualla, MD Po Box 625, 135 Hospital Dr, Camden, TN 38320 Ph: (731) 584-2117 | Dr Agustin V Vitualla, MD 135 Hospital Dr, Camden, TN 38320 Ph: (731) 584-2117 |
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