Individual
JILL SUZANNE BANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1115 20TH ST, HUNTINGTON, WV 25703-2071
(304) 691-1500
Mailing address
1448 10TH AVE STE 304, HUNTINGTON, WV 25701-3579
(304) 691-6381
(304) 691-8591
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
33534
WV
Other
Enumeration date
04/22/2020
Last updated
07/09/2024
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