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General NPI Number Information
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NPI Number | 1194045237
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Entity Type | Organization
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Legal Business Name | SPECTRUM FAMILY CARE, PLLC
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Dates
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Enumeration Date | 06/10/2010
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Last Update Date | 09/16/2010
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Provider Practice Location Address
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Address Line | 1401 HOSPITAL DR SUITE 306
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City | HURRICANE
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State | WV
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Zip | 25526-9237
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Country | US
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Telephone | 304-397-5744
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Fax | 304-757-0964
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Provider Business Mailing Address
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Address Line | 1401 HOSPITAL DR SUITE 306
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City | HURRICANE
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State | WV
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Zip | 25526-9237
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Country | US
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Telephone | 304-397-5744
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Fax | 304-757-0964
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Authorized Official
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Title or Position | BUSINESS OFFICE DIRECTOR
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Name | ANGELA D SIZEMORE
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Credential |
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Telephone | 304-397-5744
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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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