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General NPI Number Information
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NPI Number | 1730565128
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Entity Type | Organization
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Legal Business Name | TRI-COUNTY EMERGENCY PHYSICIANS LLC
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Dates
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Enumeration Date | 08/07/2015
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Last Update Date | 08/07/2015
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Provider Practice Location Address
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Address Line | 117 HOSPITAL DR
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City | PETERSBURG
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State | WV
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Zip | 26847-9566
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Country | US
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Telephone | 469-401-2386
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Fax |
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Provider Business Mailing Address
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Address Line | 13737 NOEL RD STE 1600
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City | DALLAS
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State | TX
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Zip | 75240-1331
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Country | US
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Telephone | 469-401-2386
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | ROSS RONAN
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Credential |
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Telephone | 469-401-2386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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