Healthcare Provider Details

I. General information

NPI: 1770533564
Provider Name (Legal Business Name): UNIVERSITY PHYSICIANS & SURGEONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 HOSPITAL DRIVE, KRUGER MEDICAL PLAZA SUITE 201
LOGAN WV
25601
US

IV. Provider business mailing address

1600 MEDICAL CENTER DR SUITE 2500
HUNTINGTON WV
25701-3656
US

V. Phone/Fax

Practice location:
  • Phone: 304-792-1847
  • Fax: 304-792-1849
Mailing address:
  • Phone: 304-691-1200
  • Fax: 304-691-1287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: PAM LOVINS
Title or Position: CREDENTIALING SPECIALIST
Credential: CPCS
Phone: 304-691-1640