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General NPI Number Information
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NPI Number | 1629899869
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Entity Type | Organization
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Legal Business Name | CAMDEN-CLARK PHYSICIAN CORPORATION
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 604 ANN ST
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City | PARKERSBURG
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State | WV
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Zip | 26101-5122
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Country | US
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Telephone | 304-865-5065
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Fax | 304-865-5066
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Provider Business Mailing Address
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Address Line | PO BOX 843
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City | MORGANTOWN
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State | WV
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Zip | 26507-0843
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Country | US
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Telephone | 304-285-7101
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | KYLE ANTHONY PIERSON
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Credential |
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Telephone | 304-424-2202
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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 |
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License Number State |
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