# PRESTON MEMORIAL MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grafton Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114009941
- **Authorized official:** MRS. MELISSA LOCKWOOD (CEO)
- **Authorized official phone:** (304) 329-4700

## Contact information

- **Practice address:** 500 MARKET STREET, GRAFTON CITY HOSPTIAL, GRAFTON, WV 26354
- **Practice address phone:** (304) 265-6400
- **Mailing address:** 300 S PRICE ST, KINGWOOD, WV 26537-1442
- **Mailing address phone:** (304) 329-2830
- **Mailing address fax:** (304) 791-3737

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | WV | Yes |

## Other

- **Enumeration date:** 10/20/2006
- **Last updated:** 07/29/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0007709000 | — | WV |
| 01 | — | 001710365 | HOLEHOUSE, JAMES BCBS | WV |