Organization
INTEGRATED HEALTH CARE PROVIDERS, INC.
Active
Other names
Urology Renal Transplant
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF H. GOODE MBA (PRESIDENT)
(304) 388-7782
Entity
Organization
Contact information
Practice address
501 MORRIS ST, 5 WEST, CHARLESTON, WV 25301-1326
(304) 388-7823
(304) 388-7820
Mailing address
415 MORRIS ST, SUITE 304, CHARLESTON, WV 25301-1842
(304) 388-7782
(304) 388-7788
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
—
—
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
11/09/2010
Last updated
08/27/2013
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