Individual
CURTIS BRENT PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
503 ROOSEVELT BLVD, ELEANOR, WV 25070
(304) 586-0001
(304) 586-0079
Mailing address
97 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560-9816
(304) 757-6999
(304) 757-3252
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1450
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001721667
BCBS
WV
05
—
0046893000
—
WV
05
—
0245176
—
OH
01
—
385750
FEDERAL BLACK LUNG
WV
01
—
550737600
AETNA
WA
01
—
550737600
COMMERICAL INSURANCE
WV
Enumeration date
09/21/2006
Last updated
10/15/2019
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