| NPI | 1447128434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP Of Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2025-10-29 |
| Last Update Date | 2025-10-29 |