Individual
DR. THOMAS GEORGE WACK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
616 FAIRMONT PIKE RT 88, WHEELING, WV 26003
(304) 242-3550
(304) 242-5810
Mailing address
616 FAIRMONT PIKE RT 88, PO BOX 2286, WHEELING, WV 26003
(304) 242-3550
(304) 242-5810
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11364
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0055858000
—
WV
Enumeration date
01/08/2007
Last updated
10/09/2012
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