# SOUTH HARRISON FAMILY MEDICINE

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

## Provider details

- **NPI number:** 1922197573
- **Authorized official:** DR. JO ANN LONGENECKER MD (PRESIDENT)
- **Authorized official phone:** (304) 745-3200

## Contact information

- **Practice address:** 2324 HAWK HIGHWAY, LOST CREEK, WV 26385-9707
- **Practice address phone:** (304) 745-3200
- **Practice address fax:** (304) 745-4068
- **Mailing address:** 2324 HAWK HIGHWAY, LOST CREEK, WV 26385-9707
- **Mailing address phone:** (304) 745-3200
- **Mailing address fax:** (304) 745-4068

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 15551 | WV | Yes |

## Other

- **Enumeration date:** 10/12/2006
- **Last updated:** 12/05/2011