Organization
JUSTICE MEDICAL COMPLEX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA JUSTICE (OWNER)
(304) 393-4004
Entity
Organization
Contact information
Practice address
RR BOX 330 US HWY 52, KERMIT, WV 25669
(304) 393-4004
(304) 393-4167
Mailing address
PO BOX 837, KERMIT, WV 25674-0837
(304) 393-4004
(304) 393-4167
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21730
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810004168
—
WV
05
—
65944621
—
KY
Enumeration date
10/25/2006
Last updated
08/22/2020
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