Organization
S E EMERGENCY PHYSICIANS
Active
Other names
Primary Care Plus
Organization subpart
No
Provider details
NPI number
Authorized official
RANDAL L DABBS MD (PRESIDENT)
(888) 203-1274
Entity
Organization
Contact information
Practice address
124 BROOKSHIRE LANE, BECKLEY, WV 25801-6761
(304) 255-9205
Mailing address
P O BOX 634706, CINCINNATI, OH 45263-4706
(888) 203-1274
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
WV
363A00000X
Physician Assistant
—
WV
363L00000X
Nurse Practitioner
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4005131000
—
WV
01
—
DD7401
RAILROAD MEDICARE
WV
Enumeration date
02/19/2008
Last updated
02/19/2008
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