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Organization
FAIRMONT PHYSICIANS INC
Active
Organization
FAIRMONT PHYSICIANS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE BOYLES (TREASURER)
(304) 367-7100
Entity
Organization
Contact information
Practice address
211 MARION SQUARE, FAIRMONT, WV 26554
(304) 367-0043
(304) 367-9470
Mailing address
PO BOX 2990, FAIRMONT, WV 26554
(304) 367-0043
(304) 367-9470
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
208800000X
Urology Physician
Primary
—
NULL
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009022000
—
WV
Enumeration date
06/30/2006
Last updated
03/17/2009
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