Individual
MR. JOHN TIMOTHY RUNNION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA.C
Contact information
Practice address
645 KANAWHA AVE, RAINELLE, WV 25962-1013
(304) 438-6188
(304) 438-6819
Mailing address
645 KANAWHA AVE, RAINELLE, WV 25962-1013
(304) 438-6188
(304) 438-6819
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
249
WV
363A00000X
Physician Assistant
909
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810018844
—
WV
Enumeration date
11/06/2007
Last updated
08/27/2012
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