# PRESTIGE PRIMARY CARE ASSOCIATES, PLLC

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

## Provider details

- **NPI number:** 1790819373
- **Authorized official:** DR. FRANKLIN SCOTT MOORE D.O. (OWNER)
- **Authorized official phone:** (304) 768-0700

## Contact information

- **Practice address:** 4501 MACCORKLE AVE SW, SUITE 301, SOUTH CHARLESTON, WV 25309-1444
- **Practice address phone:** (304) 768-0700
- **Practice address fax:** (304) 768-9790
- **Mailing address:** 4501 MACCORKLE AVE SW, SUITE 301, SOUTH CHARLESTON, WV 25309-1444
- **Mailing address phone:** (304) 768-0700
- **Mailing address fax:** (304) 768-9790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 1212 | WV | Yes |
| 207R00000X | Internal Medicine Physician | 1390 | WV | — |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 10/16/2007