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General NPI Number Information
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NPI Number | 1972585099
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Entity Type | Organization
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Legal Business Name | MEDEXPRESS URGENT CARE, PLLC - PARKERSBURG
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 02/14/2012
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Provider Practice Location Address
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Address Line | 1500 GRAND CENTRAL AVE STE 115
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City | VIENNA
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State | WV
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Zip | 26105-1079
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Country | US
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Telephone | 304-295-2311
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Fax | 304-295-2315
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Provider Business Mailing Address
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Address Line | PO BOX 719
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City | DELLSLOW
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State | WV
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Zip | 26531-0719
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Country | US
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Telephone | 304-985-3627
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Fax | 304-985-3630
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Authorized Official
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Title or Position | VP OF PAYOR CONTRACTING
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Name | TIMOTHY BUGIN
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Credential |
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Telephone | 304-225-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine 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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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