Healthcare Provider Details

I. General information

NPI: 1114856424
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

2107 PIKE ST STE 6
PARKERSBURG WV
26101-6973
US

IV. Provider business mailing address

PO BOX 887
MORGANTOWN WV
26507-0887
US

V. Phone/Fax

Practice location:
  • Phone: 304-865-5500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
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