# JOSEPH J DEPETRO III MD PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1245380831
- **Authorized official:** JOSEPH J DEPETRO III MD (PRESIDENT)
- **Authorized official phone:** (304) 737-0321

## Contact information

- **Practice address:** 69 8TH ST, WELLSBURG, WV 26070-1605
- **Practice address phone:** (304) 737-0321
- **Practice address fax:** (304) 737-2979
- **Mailing address:** PO BOX 6691, WHEELING, WV 26003-0913
- **Mailing address phone:** (304) 233-2455
- **Mailing address fax:** (304) 233-6073

## Taxonomy

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

## Other

- **Enumeration date:** 01/12/2007
- **Last updated:** 08/25/2014