Organization
WV SPINE AND PAIN CLINIC
Active
Organization
WV SPINE AND PAIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WEIXING WILLIAM GUO M.D. (PRESIDENT)
(304) 561-7879
Entity
Organization
Contact information
Practice address
340 STATE ST, MADISON, WV 25130-1365
(304) 561-7879
(304) 307-6619
Mailing address
PO BOX 58125, CHARLESTON, WV 25358-0125
(304) 307-6618
(304) 307-6619
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
20962
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841070000
—
WV
Enumeration date
04/10/2007
Last updated
08/22/2020
Update your record
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