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330 N. Eisehower Drive Beckley WV 25801 | |
| (304) 929-0786 | |
| (304) 929-2278 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 330 N. Eisehower Drive, Beckley, West Virginia |
| Authorized Official Name and Position | Hassan Arshad Jafary (PRESIDENT) |
| Authorized Official Contact | 3049290786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
330 N Eisenhower Dr Beckley WV 25801-4141 Ph: (304) 929-0786 | 330 N. Eisehower Drive Beckley WV 25801 Ph: (304) 929-0786 |
| NPI Number | 1316110877 |
|---|---|
| Provider Enumeration Date | 04/04/2008 |
| Last Update Date | 03/05/2013 |
| Medicare PECOS PAC ID | 5799857157 |
|---|---|
| Medicare Enrollment ID | O20080701000186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316110877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 23054 (West Virginia) | Primary |
| Provider Name | Hassan A Jafary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184771016 PECOS PAC ID: 3072685437 Enrollment ID: I20080701000173 |
| Provider Name | Kimberly D Caudell |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1417142308 PECOS PAC ID: 6406907112 Enrollment ID: I20090619000097 |
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