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1511 Johnson Ave Ste 104 Bridgeport WV 26330-1016 | |
(304) 848-0702 | |
(304) 848-0705 |
Full Name | |
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Speciality | Family Medicine |
Location | 1511 Johnson Ave, Bridgeport, West Virginia |
Authorized Official Name and Position | John C Forester (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 3046244655 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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686 South Pike St Ste A Shinnston WV 26431-1043 Ph: (304) 624-4655 | 1511 Johnson Ave Ste 104 Bridgeport WV 26330-1016 Ph: (304) 848-0702 |
NPI Number | 1619176302 |
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Provider Enumeration Date | 07/13/2007 |
Last Update Date | 01/08/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619176302 | NPI | - | NPPES |
3810009401 | Medicaid | WV |
Medbrook Medical Associates Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1370 Johnson Avenue, Bridgeport, WV 26330 Phone: 304-842-7186 Fax: 304-842-9005 | |
Mountainstate Infectious Disease, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 215 W Main St Ste B, Bridgeport, WV 26330 Phone: 301-641-1822 Fax: 304-250-9933 | |