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General NPI Number Information
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NPI Number | 1912420969
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Entity Type | Organization
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Legal Business Name | GATEWAY ENT & ALLERGY, INC
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Dates
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Enumeration Date | 07/21/2017
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Last Update Date | 04/13/2018
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Provider Practice Location Address
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Address Line | 240 GEORGE ST
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City | BECKLEY
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State | WV
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Zip | 25801-2641
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Country | US
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Telephone | 304-254-8272
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Fax | 304-254-8280
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Provider Business Mailing Address
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Address Line | PO BOX 564
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City | MABSCOTT
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State | WV
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Zip | 25871-0564
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Country | US
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Telephone |
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Fax | 304-250-9697
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. BILLIE JEAN CRIGGER
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Credential | DO
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Telephone | 304-254-8272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207YX0602X
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Taxonomy Name | Otolaryngic Allergy Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number |
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License Number State |
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