Healthcare Provider Details

I. General information

NPI: 1629907043
Provider Name (Legal Business Name): CAMDEN CLARK MEMORIAL HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1397 ELIZABETH PIKE
MINERAL WELLS WV
26150-6809
US

IV. Provider business mailing address

PO BOX 887
MORGANTOWN WV
26507-0887
US

V. Phone/Fax

Practice location:
  • Phone: 304-865-5700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KYLE ANTHONY PIERSON
Title or Position: VP FINANCE
Credential:
Phone: 304-424-2202