Individual
DR. JERRY ALLEN FOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2002 PROFESSIONAL CT, MARTINSBURG, WV 25401-8808
(304) 267-4273
(304) 267-2135
Mailing address
2002 PROFESSIONAL CT, MARTINSBURG, WV 25401-8808
(304) 267-4273
(304) 267-2135
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
13635
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0202125000
—
WV
Enumeration date
07/08/2006
Last updated
07/09/2007
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