Organization
GEOFFREY R. COUSINS, MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY R COUSINS MD (OWNER)
(304) 720-2244
Entity
Organization
Contact information
Practice address
2345 CHESTERFIELD AVE, SUITE 304, CHARLESTON, WV 25304-1062
(304) 720-2244
(304) 720-2245
Mailing address
PO BOX 4695, CHARLESTON, WV 25364-4695
(304) 720-2244
(304) 720-2245
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
21957
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002022475
BC/BS
WV
05
—
3810011619
—
WV
Enumeration date
04/04/2008
Last updated
09/02/2008
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