# MIDTOWNE FAMILY PRACTICE PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1154436004
- **Authorized official:** PAMELA P. FAULKNER DO (PHYSICIAN/OWNER)
- **Authorized official phone:** (304) 431-7100

## Contact information

- **Practice address:** 403 12TH STREET EXT, PRINCETON, WV 24740-2300
- **Practice address phone:** (304) 431-9998
- **Practice address fax:** (304) 425-0782
- **Mailing address:** PO BOX 1030, PRINCETON, WV 24740-1030
- **Mailing address phone:** (304) 431-7100
- **Mailing address fax:** (304) 431-7112

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 1040 | WV | Yes |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 04/15/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0051816000 | — | WV |