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Individual

DR. TYSHAUN M JAMES-HART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
250 STANAFORD RD, SUITE 105, BECKLEY, WV 25801-3140
(304) 254-2667
(304) 254-2732
Mailing address
PO BOX 9, HINTON, WV 25951-0009
(304) 466-2944
(304) 466-2943

Taxonomy

Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
21616
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000056944C
HUMANA
WV
01
001723603
MOUNTAIN STATE BLUE CROSS
WV
05
3810001300
WV
01
P00380544
RAILROAD MEDICARE PIN #
WV
Enumeration date
09/09/2005
Last updated
10/19/2007
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