Healthcare Provider Details

I. General information

NPI: 1477531697
Provider Name (Legal Business Name): CARLA H. MCGLONE P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 03/05/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 SPRING VALLEY DRIVE
HUNTINGTON WV
25704
US

IV. Provider business mailing address

1540 SPRING VALLEY DRIVE
HUNTINGTON WV
25704
US

V. Phone/Fax

Practice location:
  • Phone: 304-429-6741
  • Fax: 304-429-0262
Mailing address:
  • Phone: 304-429-6741
  • Fax: 304-429-0262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA390
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: