Organization
MARY LOU FRAGILE DO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY LOU FRAGILE DO (DO FAMILY PRACTICE)
(304) 647-3331
Entity
Organization
Contact information
Practice address
RR 2 BOX 171C, GREYROCK PROF PARK, LEWISBURG, WV 24901
(304) 647-3331
(304) 647-9799
Mailing address
PO BOX 1788, LEWISBURG, WV 24901
(304) 647-3331
(304) 647-9799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2003958000
—
WV
Enumeration date
07/11/2006
Last updated
08/22/2020
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