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General NPI Number Information
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NPI Number | 1235292277
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Entity Type | Individual
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Provider Name | ROY R WOLFE JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 410 CARRIAGE DR
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City | BECKLEY
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State | WV
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Zip | 25801-2806
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Country | US
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Telephone | 304-255-1541
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Fax | 304-253-7067
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Provider Business Mailing Address
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Address Line | PO BOX 463
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City | GHENT
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State | WV
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Zip | 25843-0463
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Country | US
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Telephone | 304-255-1541
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Fax | 304-253-7067
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 20401
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License Number State | WV
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