Healthcare Provider Details

I. General information

NPI: 1528269248
Provider Name (Legal Business Name): COUNTY OF PRESTON BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 W MAIN ST UNIT 203
KINGWOOD WV
26537-1131
US

IV. Provider business mailing address

106 W MAIN ST UNIT 203
KINGWOOD WV
26537-1131
US

V. Phone/Fax

Practice location:
  • Phone: 304-329-0096
  • Fax: 304-329-3103
Mailing address:
  • Phone: 304-329-0096
  • Fax: 304-329-3103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FREDRICK A CONLEY II
Title or Position: HEALTH OFFICER
Credential: MD
Phone: 304-329-0096