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Individual

DR. PAUL J CLANCY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-6819
(304) 927-6837
Mailing address
200 HOSPITAL DR, SPENCER, WV 25276-1050

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
18263
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001718060
WV BCBS
WV
05
0046206000
WV
01
1053515
WV DWC
WV
01
930114604
CH1 RAILROAD MEDICARE
WV
01
930118819
CH2 RAILROAD MEDICARE
WV
Enumeration date
12/29/2005
Last updated
01/20/2011
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