Individual
JUSTIN KIEL MEDLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
610 CHESTNUT ST, SOUTH CHARLESTON, WV 25309-1251
(304) 766-7515
(304) 766-7566
Mailing address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 414-4800
(304) 766-7566
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
577
WV
Other
Enumeration date
12/05/2011
Last updated
12/30/2021
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