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General NPI Number Information
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NPI Number | 1841261815
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Entity Type | Individual
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Provider Name | KELLY P. CUMMINGS P.A.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 04/10/2012
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Provider Practice Location Address
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Address Line | 2311 OHIO AVE
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City | PARKERSBURG
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State | WV
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Zip | 26101-2559
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Country | US
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Telephone | 304-422-5114
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Fax | 304-422-5751
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Provider Business Mailing Address
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Address Line | 2311 OHIO AVE
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City | PARKERSBURG
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State | WV
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Zip | 26101-2559
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Country | US
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Telephone | 304-422-5114
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Fax | 304-422-5751
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA580
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License Number State | KY
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