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General NPI Number Information
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NPI Number | 1386760502
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Entity Type | Organization
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Legal Business Name | TEAYS VALLEY EMERGENCY PHYSICIANS, INC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 09/15/2010
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Provider Practice Location Address
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Address Line | 1400 HOSPITAL DR
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City | HURRICANE
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State | WV
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Zip | 25526-9202
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Country | US
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Telephone | 304-757-1700
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Fax | 937-619-4150
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Provider Business Mailing Address
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Address Line | 4750 HEMPSTEAD STATION DR
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City | KETTERING
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State | OH
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Zip | 45429-5164
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Country | US
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Telephone | 800-875-0136
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Fax | 937-619-4150
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Authorized Official
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Title or Position | CEO
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Name | DR. WILLIAM A COLE JR.
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Credential |
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Telephone | 800-875-0136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State | WV
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