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General NPI Number Information
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NPI Number | 1831250307
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Entity Type | Organization
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Legal Business Name | MORGAN COUNTY
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | 4275 N SR376 NW
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City | MCCONNELSVILLE
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State | OH
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Zip | 43756
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Country | US
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Telephone | 740-962-4572
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Fax |
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Provider Business Mailing Address
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Address Line | 4275 N SR376 NW
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City | MCCONNELSVILLE
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State | OH
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Zip | 43756
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Country | US
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Telephone | 740-962-4572
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Fax |
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Authorized Official
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Title or Position | HEALTH COMMISSIONER
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Name | DR. RICHARD D CLARK
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Credential | M.D.
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Telephone | 740-962-4572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 36D0860081
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License Number State | OH
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