Healthcare Provider Details

I. General information

NPI: 1679768121
Provider Name (Legal Business Name): ROBERT WILLIAM BESS JR MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 ASHFIELD ST
PIEDMONT WV
26750-1300
US

IV. Provider business mailing address

122 ASHFIELD ST
PIEDMONT WV
26750-1300
US

V. Phone/Fax

Practice location:
  • Phone: 304-355-2323
  • Fax:
Mailing address:
  • Phone: 304-355-2323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number08185
License Number StateWV

VIII. Authorized Official

Name: ROBERT BESS
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 304-355-2323