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Individual

JACKIE R STINES JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 MEDICAL CENTER DRIVE, STE 3500, HUNTINGTON, WV 25701
(304) 691-1300
(304) 691-1375
Mailing address
1600 MEDICAL CENTER DRIVE, STE 3500, HUNTINGTON, WV 25701
(304) 691-1300
(304) 691-1375

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
24389
WV
2080P0202X
Pediatric Cardiology Physician
Primary
24389
WV

Other

Enumeration date
05/09/2007
Last updated
12/09/2021
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