# STATE OF WEST VIRGINIA CONCORD UNIVERSITY

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

## Provider details

- **NPI number:** 1194287565
- **Authorized official:** DR. HUGH DAVID CAMPBELL PHD (DIRECTOR OF HEALTH SERVICES)
- **Authorized official phone:** (304) 384-5331

## Contact information

- **Practice address:** 1000 VERMILLION ST, ATHENS, WV 24712-9027
- **Practice address phone:** (304) 384-7325
- **Mailing address:** PO BOX 1000, ATHENS, WV 24712-1000
- **Mailing address phone:** (304) 384-5608

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PS0010X | Sports Medicine (Emergency Medicine) Physician | — | NULL | — |
| 207PS0010X | Sports Medicine (Emergency Medicine) Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 2255A2300X | Athletic Trainer | — | NULL | — |
| 2255A2300X | Athletic Trainer | — | — | — |
| 261QS1000X | Student Health Clinic/Center | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 04/03/2019
- **Last updated:** 11/29/2023