# BENWOOD MEDICAL CLINIC INC

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

## Provider details

- **NPI number:** 1497861819
- **Authorized official:** MR. LAWRENCE CHARLES KELLY DO (PRESIDENT OWNER)
- **Authorized official phone:** (304) 233-1656

## Contact information

- **Practice address:** 4850 EOFF ST, BENWOOD, WV 26031-1008
- **Practice address phone:** (304) 233-1656
- **Practice address fax:** (304) 233-1667
- **Mailing address:** 4850 EOFF ST, BENWOOD, WV 26031-1008
- **Mailing address phone:** (304) 233-1656
- **Mailing address fax:** (304) 233-1667

## Taxonomy

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

## Other

- **Enumeration date:** 08/21/2006
- **Last updated:** 08/22/2020