Individual
EVA PATTON TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1249 15TH ST, SUITE 2000, HUNTINGTON, WV 25701-3662
(304) 691-1000
(304) 691-1693
Mailing address
1249 15TH ST, SUITE 2000, HUNTINGTON, WV 25701-3662
(304) 691-1000
(304) 691-1693
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23727
WV
208000000X
Pediatrics Physician
23727
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810015642
—
WV
Enumeration date
05/14/2007
Last updated
11/18/2021
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