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2801 Dudley Ave Suite B Parkersburg WV 26101-2105 | |
| (304) 428-1114 | |
| (304) 428-1135 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Geriatric Psychiatry |
| Location | 2801 Dudley Ave, Parkersburg, West Virginia |
| Authorized Official Name and Position | Lance Mccoy (PRESIDENT) |
| Authorized Official Contact | 3044281114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2801 Dudley Ave Suite B Parkersburg WV 26101-2105 Ph: (304) 428-1114 | 2801 Dudley Ave Suite B Parkersburg WV 26101-2105 Ph: (304) 428-1114 |
| NPI Number | 1396797825 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 11/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396797825 | NPI | - | NPPES |
| 2809090 | Medicaid | OH | |
| 3810010872 | Medicaid | WV |
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