# MARIETTA MEMORIAL HOSPITAL OF TYLER COUNTY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Professional Services Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144800673
- **Authorized official:** PAUL G WESTBROCK (VP, LEGAL AFFAIRS)
- **Authorized official phone:** (740) 374-1581

## Contact information

- **Practice address:** 314 S WELLS ST, SISTERSVILLE, WV 26175-1098
- **Practice address phone:** (304) 652-2611
- **Mailing address:** C/O PAUL WESTBROCK, 314 S WELLS ST, SISTERSVILLE, WV 26175
- **Mailing address phone:** (740) 374-1581

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 04/09/2021
- **Last updated:** 05/14/2021