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Organization

BECKLEY PEDIATRIC ASSOCIATES LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN H JOHNSON III MD (OWNER/PHYSICIAN)
(304) 255-0800
Entity
Organization

Contact information

Practice address
30 MALLARD CT, BECKLEY, WV 25801-3664
(304) 255-0800
(304) 255-1040
Mailing address
PO BOX 460, WHITE SULPHUR SPRINGS, WV 24986-0460
(304) 536-5030
(304) 536-5031

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810004859
WV
Enumeration date
06/20/2006
Last updated
01/12/2012
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