Healthcare Provider Details
I. General information
NPI: 1972446813
Provider Name (Legal Business Name): SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14689 GARRETT HWY STE 3
OAKLAND MD
21550-4059
US
IV. Provider business mailing address
PO BOX 1647
MORGANTOWN WV
26507-1647
US
V. Phone/Fax
- Phone: 301-859-7178
- Fax: 240-270-5222
- Phone: 304-974-5000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LORI
DIXON
Title or Position: DIRECTOR FINANCE
Credential:
Phone: 301-533-4251