Jackie R Stines Jr, MD | |
1600 Medical Center Drive, Ste 3500, Huntington, WV 25701 | |
(304) 691-1300 | |
(304) 691-1375 |
Full Name | Jackie R Stines Jr |
---|---|
Gender | Male |
Speciality | Pediatrics - Pediatric Cardiology |
Location | 1600 Medical Center Drive, Huntington, 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 |
---|---|---|---|
1023222197 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 24389 (West Virginia) | Secondary |
2080P0202X | Pediatrics - Pediatric Cardiology | 24389 (West Virginia) | Primary |
Entity Name | University Physicians & Surgeons, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1730183286 PECOS PAC ID: 2961315734 Enrollment ID: O20031107000331 |
Entity Name | West Virginia University Medical Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275504508 PECOS PAC ID: 1052224565 Enrollment ID: O20031111000207 |
Mailing Address | Practice Location Address |
---|---|
Jackie R Stines Jr, MD 1600 Medical Center Drive, Ste 3500, Huntington, WV 25701 Ph: (304) 691-1300 | Jackie R Stines Jr, MD 1600 Medical Center Drive, Ste 3500, Huntington, WV 25701 Ph: (304) 691-1300 |
Dr. Tanya G Bigby, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5187 Us Route 60 E, Ste 11, Huntington, WV 25705 Phone: 304-399-5437 Fax: 304-399-1104 | |
Kate M. Waldeck, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1600 Medical Center Dr Ste 3500, Huntington, WV 25701 Phone: 304-691-1300 | |
Sherrie N Miranda, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1600 Medical Center Dr, Suite 3500, Huntington, WV 25701 Phone: 304-691-1300 Fax: 304-691-1375 | |
Jessie Shields, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1600 Medical Center Dr, Sutie 3500, Huntington, WV 25701 Phone: 304-691-1300 Fax: 304-691-1375 | |
Dr. Rose Mary Ayoob, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1600 Medical Center Dr Ste 3500, Huntington, WV 25701 Phone: 304-691-1300 Fax: 304-691-1375 | |
Jennifer K Gerlach, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1600 Medical Center Dr, Ste 3500, Huntington, WV 25701 Phone: 304-691-1300 Fax: 304-691-1375 |