Individual
JEFFREY REED MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1606 KANAWHA BLVD W, CHARLESTON, WV 25387-2536
(304) 768-8523
(304) 941-1918
Mailing address
1606 KANAWHA BLVD W, CHARLESTON, WV 25387-2536
(304) 768-8523
(304) 941-1918
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1601
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0048360000
—
WV
Enumeration date
03/17/2006
Last updated
10/23/2015
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