Organization
LIBERTY CIRCLE EAR NOSE & THROAT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICARDO ARTURO ROA M.D. (SOLE MEMBER/MEDICAL DIRECTOR)
(740) 886-9370
Entity
Organization
Contact information
Practice address
1340 HAL GREER BLVD, HUNTINGTON, WV 25701-3800
(740) 886-9370
(740) 886-9374
Mailing address
96 TOWNSHIP ROAD 369 SUITE 101, PROCTORVILLE, OH 45669
(740) 886-9370
(740) 886-9374
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
17624
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0954356
—
OH
05
—
3810004605
—
WV
Enumeration date
05/26/2006
Last updated
08/22/2020
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