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General NPI Number Information
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NPI Number | 1255546750
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Entity Type | Organization
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Legal Business Name | WILLIAM A SANPABLO
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 2 HEALTH CARE DRIVE
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City | PHILIPPI
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State | WV
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Zip | 26416-0070
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Country | US
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Telephone | 304-457-1306
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Fax | 304-457-1307
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Provider Business Mailing Address
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Address Line | PO BOX 70
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City | PHILIPPI
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State | WV
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Zip | 26416-0070
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Country | US
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Telephone | 304-457-1306
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Fax | 304-457-1307
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Authorized Official
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Title or Position | PHYSICIAL
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Name | DR. WILLIAM A SAN PABLO
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Credential | M.D.
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Telephone | 304-457-1306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | WV11963
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License Number State | WV
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