Antonio R Diaz Jr, MD | |
174 Lmah Center Rd, Logan, WV 25601-4058 | |
(304) 792-7130 | |
Not Available |
Full Name | Antonio R Diaz Jr |
---|---|
Gender | Male |
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 174 Lmah Center Rd, Logan, West Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053339135 | NPI | - | NPPES |
0288291 | Medicaid | OH | |
1493983 | Other | WV | UMWA |
550751751 | Other | WV | BLUE CROSS/BLUE SHIELD |
64940489 | Medicaid | KY | |
000706447 | Other | BLUE CROSS/BLUE SHIELD | |
0115148000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 16814 (West Virginia) | Primary |
Mailing Address | Practice Location Address |
---|---|
Antonio R Diaz Jr, MD Po Box 176, Logan, WV 25601-0176 Ph: (304) 792-7130 | Antonio R Diaz Jr, MD 174 Lmah Center Rd, Logan, WV 25601-4058 Ph: (304) 792-7130 |
Dr. John David Justice, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: Route 10, Three Mile Curve, Logan, WV 25601 Phone: 304-792-7130 Fax: 304-792-7138 |