# INTEGRATED HEALTH CARE PROVIDERS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Urology Center Madison
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699007864
- **Authorized official:** JEFFREY H. GOODE MBA (PRESIDENT)
- **Authorized official phone:** (304) 388-7782

## Contact information

- **Practice address:** 467 MAIN ST, SUITE 200, MADISON, WV 25130-2200
- **Practice address phone:** (304) 369-5170
- **Practice address fax:** (304) 369-0946
- **Mailing address:** 415 MORRIS ST, SUITE 304, CHARLESTON, WV 25301-1842
- **Mailing address phone:** (304) 388-7782
- **Mailing address fax:** (304) 388-7788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/12/2010
- **Last updated:** 02/12/2010