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General NPI Number Information
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NPI Number | 1811372030
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Entity Type | Organization
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Legal Business Name | CAMDEN CLARK MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 600 18TH ST STE 606
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City | PARKERSBURG
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State | WV
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Zip | 26101-3236
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Country | US
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Telephone | 304-424-3588
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Fax |
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Provider Business Mailing Address
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Address Line | 600 18TH ST STE 606
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City | PARKERSBURG
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State | WV
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Zip | 26101-3236
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JENNIFER LEAVITT
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Credential | DO
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Telephone | 304-424-4588
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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 |
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License Number State |
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