| Jefferson Primary Care | |
|
116 E 3rd Ave Ranson WV 25438-1641 | |
| (304) 724-7200 | |
| (304) 724-7208 |
| Full Name | Jefferson Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 116 E 3rd Ave, Ranson, West Virginia |
| Authorized Official Name and Position | Safa Mohamed Osman (SOLE PROPRIETOR) |
| Authorized Official Contact | 3047247200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Primary Care Po Box 69 Ranson WV 25438-0069 Ph: (304) 724-7200 | Jefferson Primary Care 116 E 3rd Ave Ranson WV 25438-1641 Ph: (304) 724-7200 |
| NPI Number | 1124247127 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 03/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124247127 | NPI | - | NPPES |
| 0207571000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101241056 (West Virginia) | Primary |
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