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General NPI Number Information
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NPI Number | 1174476295
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Entity Type | Organization
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Legal Business Name | FAYETTE PHYSICIAN NETWORK INC
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Dates
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Enumeration Date | 02/18/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 1085 VAN VOORHIS RD STE 130
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City | MORGANTOWN
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State | WV
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Zip | 26505-3497
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Country | US
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Telephone | 304-599-2273
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 796
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City | MORGANTOWN
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State | WV
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Zip | 26507-0796
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ACCOUNTING
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Name | JAMES JONES
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Credential |
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Telephone | 304-282-1611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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