# MAIN STREET FAMILY PRACTICE, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073542809
- **Authorized official:** KENNETH SELLS DO (PRESIDENT)
- **Authorized official phone:** (304) 752-3400

## Contact information

- **Practice address:** 533 MAIN ST, LOGAN, WV 25601-3809
- **Practice address phone:** (304) 752-3400
- **Practice address fax:** (304) 752-8138
- **Mailing address:** 533 MAIN ST, LOGAN, WV 25601-3809
- **Mailing address phone:** (304) 752-3400
- **Mailing address fax:** (304) 752-8138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 016632 | WV | Yes |

## Other

- **Enumeration date:** 07/02/2006
- **Last updated:** 04/24/2026