| Tygart Valley Medical Specialties, Inc | |
|
911 Gorman Ave Ste 201 Elkins WV 26241-3154 | |
| (304) 637-6302 | |
| (304) 637-6307 |
| Full Name | Tygart Valley Medical Specialties, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 911 Gorman Ave Ste 201, Elkins, West Virginia |
| Authorized Official Name and Position | Stephen Cross (CEO) |
| Authorized Official Contact | 3046376302 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tygart Valley Medical Specialties, Inc 911 Gorman Avenue Suite 201 Elkins WV 26241 Ph: (304) 637-6302 | Tygart Valley Medical Specialties, Inc 911 Gorman Ave Ste 201 Elkins WV 26241-3154 Ph: (304) 637-6302 |
| NPI Number | 1235596677 |
|---|---|
| Provider Enumeration Date | 01/15/2016 |
| Last Update Date | 03/16/2016 |
| Medicare PECOS PAC ID | 7416241351 |
|---|---|
| Medicare Enrollment ID | O20160816000329 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235596677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 21597 (West Virginia) | Primary |
| Provider Name | Jenny L Cross |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1487858775 PECOS PAC ID: 3577655406 Enrollment ID: I20070823000642 |
| Provider Name | Anna T Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003318841 PECOS PAC ID: 0547515413 Enrollment ID: I20180618000583 |
| Provider Name | Jessica R Toney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376118232 PECOS PAC ID: 1951790823 Enrollment ID: I20211115001925 |
| Provider Name | Angela M Sturdivant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942955570 PECOS PAC ID: 2466839493 Enrollment ID: I20220513000407 |
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