Healthcare Provider Details

I. General information

NPI: 1356125835
Provider Name (Legal Business Name): WEST VIRGINIA FOOT & ANKLE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KENTON DR STE 100
CHARLESTON WV
25311-1256
US

IV. Provider business mailing address

100 TRACY WAY
CHARLESTON WV
25311-1257
US

V. Phone/Fax

Practice location:
  • Phone: 304-306-8990
  • Fax: 877-471-5976
Mailing address:
  • Phone: 304-343-4583
  • Fax: 304-343-9207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: CARRIE PARRIS FRAME
Title or Position: MANAGING SHAREHOLDER
Credential: DPM
Phone: 304-306-8990