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NPI Code Detail

MEDICARE: DAVID J. HUMPHREYS, MD, PSYCHIATRIST INC.

MEDICARE: DAVID J. HUMPHREYS, MD, PSYCHIATRIST INC.
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
12084P0800XPsychiatry Physician14902WV

General Provider Information

NPI Number : 1891954384
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID J. HUMPHREYS, MD, PSYCHIATRIST INC.
Provider Business Mailing Address
First Line : 1225 6TH AVE
Second Line :
City : HUNTINGTON
State : WV
Zip : 25701-2311
Country : US
Telephone Number : 304-526-9189
Fax Number : 304-526-9989
Provider Business Practice Location Address
First Line : 1225 6TH AVE
Second Line :
City : HUNTINGTON
State : WV
Zip : 25701-2311
Country : US
Telephone Number : 304-526-9189
Fax Number : 304-526-9989
Authorized Official
Title or Position : PRESIDENT
Name : DR. DAVID JOHN HUMPHREYS
Credential : M.D.
Telephone Number : 304-526-9189
Provider Enumeration Date : 06/09/2008
Last Update Date : 06/13/2008

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