Healthcare Provider Details

I. General information

NPI: 1265505143
Provider Name (Legal Business Name): CABELL-HUNTINGTON HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 11/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 SEVENTH AVENUE
HUNTINGTON WV
25701-2115
US

IV. Provider business mailing address

703 SEVENTH AVENUE
HUNTINGTON WV
25701-2115
US

V. Phone/Fax

Practice location:
  • Phone: 304-523-6483
  • Fax: 304-523-6482
Mailing address:
  • Phone: 304-523-6483
  • Fax: 304-523-6482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number StateWV

VIII. Authorized Official

Name: MR. TIMOTHY D HAZELETT
Title or Position: ADMINISTRATOR
Credential:
Phone: 304-523-6483