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NPI Code Detail

MEDICARE: JOHN J AZAR MD, FACP

MEDICARE: JOHN J AZAR MD, FACP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0003XHematology & Oncology Physician17192WV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CH6378OTHERRR MEDICARE
3830005456OTHERWVRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4WV17192OTHERWVHEALTH PLAN

General Provider Information

NPI Number : 1407840572
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN J AZAR MD, FACP
Provider Business Mailing Address
First Line : PO BOX 1286
Second Line :
City : FAIRMONT
State : WV
Zip : 26555-1286
Country : US
Telephone Number : 304-366-0111
Fax Number : 304-366-2099
Provider Business Practice Location Address
First Line : 1200 J D ANDERSON DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-3494
Country : US
Telephone Number : 304-598-6560
Fax Number : 304-285-2667
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2005
Last Update Date : 10/20/2016

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