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General NPI Number Information
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NPI Number | 1770594475
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Entity Type | Individual
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Provider Name | JILL TRACEY SCHENK MD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 1600 MEDICAL CENTER DRIVE SUITE 1500
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City | HUNTINGTON
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State | WV
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Zip | 25701-3657
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Country | US
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Telephone | 304-691-1100
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Fax | 304-691-1153
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Provider Business Mailing Address
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Address Line | 1448 10TH AVE STE 304
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City | HUNTINGTON
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State | WV
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Zip | 25701-3579
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Country | US
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Telephone | 304-691-6381
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Fax | 304-691-8591
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146D00000X
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Taxonomy Name | Personal Emergency Response Attendant
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License Number | A87051
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR-50806
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A87051
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 04-49107
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License Number State | KS
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 64183-20
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License Number State | WI
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 33726
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License Number State | WV
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