Full Name | |
---|---|
Speciality | Family Medicine |
Location | Memorial Dr, Petersburg, West Virginia |
Authorized Official Name and Position | Larry C Rogers (OWNER) |
Authorized Official Contact | 3042574511 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Memorial Dr Box 7 Petersburg WV 26847 Ph: (304) 257-4511 | Memorial Dr Petersburg WV 26847 Ph: (304) 257-4511 |
NPI Number | 1538347943 |
---|---|
Provider Enumeration Date | 02/07/2008 |
Last Update Date | 08/19/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538347943 | NPI | - | NPPES |
0055759000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
South Branch Hospitalist And Internal Medicine Group Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 65 Hospital Dr Ste 102, Petersburg, WV 26847 Phone: 304-257-2527 Fax: 304-257-1469 | |
Dewey F Bensenhaver Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Hc 30 Box 95, Petersburg, WV 26847 Phone: 304-257-1456 | |