Healthcare Provider Details

I. General information

NPI: 1598824567
Provider Name (Legal Business Name): JAMES R. DINGESS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 WEST COUNTRY CLUB DR
HUNTINGTON WV
25705
US

IV. Provider business mailing address

1811 SYCAMORE ST APARTMENT 1
KENOVA WV
25530-1638
US

V. Phone/Fax

Practice location:
  • Phone: 304-733-1060
  • Fax:
Mailing address:
  • Phone: 304-453-5652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberC1543
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: