# MOUNTAIN STATE ENT & FACIAL PLASTIC SURGERY, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Mountain State ENT, Mountain State ENT and Facial Plastic Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982604997
- **Authorized official:** ALBERT JAMES PAINE JR. MD (OWNER; PRESIDENT)
- **Authorized official phone:** (304) 255-2341

## Contact information

- **Practice address:** 78 BROOKSHIRE LN, BECKLEY, WV 25801-6765
- **Practice address phone:** (304) 255-2341
- **Practice address fax:** (304) 255-2343
- **Mailing address:** 78 BROOKSHIRE LN, BECKLEY, WV 25801-6765
- **Mailing address phone:** (304) 255-2341
- **Mailing address fax:** (304) 255-2343

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 006769 | WV | Yes |

## Other

- **Enumeration date:** 08/01/2005
- **Last updated:** 03/29/2024