Dr Jack F Ditty Iii, MD | |
101 Stadium Drive, Morgantown, WV 26505 | |
(304) 598-4000 | |
(304) 293-6963 |
Full Name | Dr Jack F Ditty Iii |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 101 Stadium Drive, Morgantown, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043390925 | NPI | - | NPPES |
3810002302 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 21600 (West Virginia) | Primary |
Entity Name | Southeastern Emergency Physicians Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050415000720 |
Mailing Address | Practice Location Address |
---|---|
Dr Jack F Ditty Iii, MD P. O. Box 897, Morgantown, WV 26507-0897 Ph: (304) 293-7401 | Dr Jack F Ditty Iii, MD 101 Stadium Drive, Morgantown, WV 26505 Ph: (304) 598-4000 |
Dr. Nicole Lee Dorinzi, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: One Medical Center Drive, Po 9149, Morgantown, WV 26506 Phone: 304-216-0980 | |
Kevin J Blankenship, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 63 Wharf St, Suite 100, Morgantown, WV 26501 Phone: 304-291-3627 Fax: 304-598-3630 | |
Dr. Christopher Edwards, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1200 J D Anderson Dr, Morgantown, WV 26505 Phone: 304-598-1200 | |
Dr. John Harold Marsh, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1200 J D Anderson Dr, Emergency Department, Morgantown, WV 26505 Phone: 304-598-1200 | |
Matthew Kersteter, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Center Drive, Po 9149, Morgantown, WV 26506 Phone: 304-293-7215 Fax: 304-293-6702 | |
Dr. Maria Ann Long, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 101 Stadium Dr, Morgantown, WV 26506 Phone: 304-293-2436 Fax: 304-293-6702 |