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General NPI Number Information
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NPI Number | 1669480323
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Entity Type | Organization
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Legal Business Name | KELL WEST REGIONAL HOSPITAL LLC
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 09/16/2010
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Provider Practice Location Address
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Address Line | 5420 KELL BLVD
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City | WICHITA FALLS
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State | TX
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Zip | 76310-1610
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Country | US
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Telephone | 940-692-5888
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Fax | 940-692-0915
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Provider Business Mailing Address
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Address Line | 5420 KELL BLVD
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City | WICHITA FALLS
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State | TX
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Zip | 76310-1610
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Country | US
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Telephone | 940-692-5888
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Fax | 940-692-0915
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Authorized Official
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Title or Position | CEO
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Name | DR. JERRY K MYERS
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Credential | MD
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Telephone | 940-692-5888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 006814
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License Number State | TX
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