Organization
SOUTH CHARLESTON PRIMARY CARE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY SUE KING (OFFICE MANAGER)
(304) 744-4532
Entity
Organization
Contact information
Practice address
312 6TH AVE, SUITE 3, SOUTH CHARLESTON, WV 25303-1242
(304) 744-4532
(304) 744-3219
Mailing address
312 6TH AVE, SUITE 3, SOUTH CHARLESTON, WV 25303-1242
(304) 744-4532
(304) 744-3219
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10611
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009405000
—
WV
Enumeration date
10/11/2006
Last updated
11/11/2013
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