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General NPI Number Information
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NPI Number | 1326103631
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Entity Type | Individual
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Provider Name | HOYT JEFFERY BURDICK M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1340 HAL GREER BLVD
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City | HUNTINGTON
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State | WV
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Zip | 25701-3800
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Country | US
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Telephone | 304-526-2064
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Fax | 304-526-4883
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Provider Business Mailing Address
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Address Line | 90 FAIRFAX DR
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City | HUNTINGTON
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State | WV
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Zip | 25705-1330
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Country | US
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Telephone | 304-526-2064
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Fax | 304-526-4883
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 14255
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License Number State | WV
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