Individual
MR. KELLY MCCOY PITSENBARGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
126 CARPENTER ST, SHADY SPRING, WV 25918-8417
(304) 255-2426
(304) 253-3715
Mailing address
PO BOX 1437, SHADY SPRING, WV 25918-1437
(304) 255-2426
(304) 253-3715
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
WV13927
WV
Other
Enumeration date
09/27/2005
Last updated
10/23/2024
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