# ENVISION MEDICAL CARE, LLC

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

## Provider details

- **NPI number:** 1194338244
- **Authorized official:** J CLAY NP-C (CEO)
- **Authorized official phone:** (304) 372-1030

## Contact information

- **Practice address:** 111 COURT ST S STE B, RIPLEY, WV 25271-1408
- **Practice address phone:** (304) 372-1030
- **Mailing address:** 111 COURT ST S STE B, RIPLEY, WV 25271-1408
- **Mailing address phone:** (304) 372-1030

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | NULL | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 08/28/2020
- **Last updated:** 12/02/2021