Healthcare Provider Details

I. General information

NPI: 1558142265
Provider Name (Legal Business Name): RODNEY ALLEN TWYMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 8TH AVE STE 2
HUNTINGTON WV
25703-1702
US

IV. Provider business mailing address

38 POGUE ST
HUNTINGTON WV
25705-1509
US

V. Phone/Fax

Practice location:
  • Phone: 304-962-2087
  • Fax: 304-523-9084
Mailing address:
  • Phone: 304-939-2192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: