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General NPI Number Information
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NPI Number | 1336487321
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Entity Type | Organization
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Legal Business Name | DHP OF FAIRMONT INC
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Dates
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Enumeration Date | 01/25/2013
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | 1325 LOCUST AVE
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City | FAIRMONT
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State | WV
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Zip | 26554-1435
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Country | US
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Telephone | 304-333-8305
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Fax | 919-655-1330
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Provider Business Mailing Address
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Address Line | PO BOX 638073
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City | CINCINNATI
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State | OH
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Zip | 45263-8073
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Country | US
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Telephone | 330-470-3700
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Fax | 330-497-7940
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | RANDAL DABBS
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Credential | MD
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Telephone | 865-693-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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