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Organization
MIDTOWNE FAMILY PRACTICE PLLC
Active
Organization
MIDTOWNE FAMILY PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA P. FAULKNER DO (PHYSICIAN/OWNER)
(304) 431-7100
Entity
Organization
Contact information
Practice address
403 12TH STREET EXT, PRINCETON, WV 24740-2300
(304) 431-9998
(304) 425-0782
Mailing address
PO BOX 1030, PRINCETON, WV 24740-1030
(304) 431-7100
(304) 431-7112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1040
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051816000
—
WV
Enumeration date
08/20/2006
Last updated
04/15/2024
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