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Organization

GREENBRIER VALLEY UROLOGY ASSOCIATES, INC

Active
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Organization

GREENBRIER VALLEY UROLOGY ASSOCIATES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KYLE F FORT (MD PRESIDENT)
(304) 647-5642
Entity
Organization

Contact information

Practice address
119 MAPLEWOOD AVE, RONCEVERTE, WV 24970-9737
(304) 647-5642
(304) 647-5644
Mailing address
119 MAPLEWOOD AVE, RONCEVERTE, WV 24970-9737
(304) 647-5642
(304) 647-5644

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
NULL
208800000X
Urology Physician
Primary
—
—

Other

Enumeration date
09/23/2005
Last updated
02/11/2014
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