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Organization
MOUNTAIN STATE ORTHOPEDICS & SPORTS MEDICINE
Active
Organization
MOUNTAIN STATE ORTHOPEDICS & SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM R. CARSON M.D. (PRESIDENT)
(304) 880-7988
Entity
Organization
Contact information
Practice address
400 FAIRVIEW HEIGHTS RD, STE. 301, SUMMERSVILLE, WV 26651-9308
(304) 880-7988
(304) 880-7987
Mailing address
PO BOX 927, SUMMERSVILLE, WV 26651-0927
(304) 880-7988
(304) 880-7987
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
WV18114
WV
Other
Enumeration date
10/01/2007
Last updated
12/29/2008
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