Organization
BLUE LOT MD PLLC
Active
Parent organization
BLUE LOT MD PLLC
Other names
Dr. Letitia Tierney
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLUE LOT MD PLLC
Authorized official
DR. LETITIA ELAINE TIERNEY MD (SOLE MEMBER)
(304) 344-2345
Entity
Organization
Contact information
Practice address
10 COURTNEY DR, CHARLESTON, WV 25304-2699
(304) 344-2345
(304) 400-4645
Mailing address
10 COURTNEY DR, CHARLESTON, WV 25304-2699
(304) 344-2345
(304) 400-4645
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810017636
—
WV
Enumeration date
07/07/2022
Last updated
08/04/2022
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