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Contact Information

LEVI S WIDENER
245 MEDICAL PARK DR STE B
MARION, VA24354
 Phone: 276-378-3020
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for LEVI S WIDENER · (Male)

NPI Number 1306512371
Status Active
Credentials
Entity Individual
Enumeration date 08/19/2021
Last updated 12/05/2025 - About 6 months ago
Sole proprietor 1 No
Identifiers
  • TN License # 4743
  • VA License # 0110008072
Hospital affiliation(s)
  • JOHNSTON MEMORIAL HOSPITAL - (Acute Care)
    16000 JOHNSTON MEMORIAL DRIVE
    ABINGDON, VA 24211
  • RUSSELL COUNTY MEDICAL CENTER - (Acute Care)
    58 CARROLL STREET
    LEBANON, VA 24266
  • WELLMONT BRISTOL REGIONAL MEDICAL CENTER - (Acute Care)
    ONE MEDICAL PARK BLVD
    BRISTOL, TN 37620
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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