Full Name | |
---|---|
Speciality | Family Medicine |
Location | Route 92, Green Bank, West Virginia |
Authorized Official Name and Position | John C Sharp (OWNER) |
Authorized Official Contact | 3047994645 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
P O Box 320 Marlinton WV 24954 Ph: (304) 456-4211 | Route 92 Green Bank WV 24944 Ph: (304) 456-4211 |
NPI Number | 1275610230 |
---|---|
Provider Enumeration Date | 11/01/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275610230 | NPI | - | NPPES |
3810005779 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 806 (West Virginia) | Primary |