Healthcare Provider Details

I. General information

NPI: 1679895320
Provider Name (Legal Business Name): ELIZABETH LEANN ACCORD D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH LEANN ASBURY D.O.

II. Dates (important events)

Enumeration Date: 02/23/2010
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 MIDDLETOWN CMNS STE 163
FAIRMONT WV
26554-2882
US

IV. Provider business mailing address

1247 SUNCREST TOWNE CENTRE
MORGANTOWN WV
26505
US

V. Phone/Fax

Practice location:
  • Phone: 304-599-8000
  • Fax:
Mailing address:
  • Phone: 304-599-8000
  • Fax: 304-599-8003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2727
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: