Individual
DR. JEREMY A PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1464 JEFFERSON ST N, LEWISBURG, WV 24901-1380
(304) 645-3220
(304) 645-4103
Mailing address
1464 JEFFERSON ST N, LEWISBURG, WV 24901-1380
(304) 645-3220
(304) 645-4103
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
DO3504
ME
207Q00000X
Family Medicine Physician
Primary
2524
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810023389
—
WV
Enumeration date
08/20/2009
Last updated
02/15/2023
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