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Organization

WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION

Active
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Organization subpart
Yes

Provider details

NPI number
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Authorized official
JUSTIN GIBSON (VP OF FINANCE)
(304) 598-4256
Entity
Organization

Contact information

Practice address
33 MEDICAL CENTER DR, MORGANTOWN, WV 26505-4024
(304) 598-4740
(304) 293-3766
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
103TC0700X
Clinical Psychologist
103TC2200X
Clinical Child & Adolescent Psychologist
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
2084P0800X
Psychiatry Physician
Primary
2084P0805X
Geriatric Psychiatry Physician

Other

Enumeration date
04/09/2025
Last updated
04/09/2025
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