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General NPI Number Information
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NPI Number | 1922063502
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Entity Type | Individual
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Provider Name | JAY T NAEGELE MD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 6007 ROUTE 60 EAST SUITE 203
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City | BARBOURSVILLE
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State | WV
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Zip | 25504
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Country | US
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Telephone | 304-733-9270
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Fax | 304-733-9087
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Provider Business Mailing Address
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Address Line | 5170 US ROUTE 60 E
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City | HUNTINGTON
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State | WV
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Zip | 25705-2065
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Country | US
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Telephone | 304-399-4422
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Fax | 304-399-4433
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 20083
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License Number State | WV
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