Organization
CORNERSTONE HEALTH CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI L LYONS (OFFICE MANAGER)
(304) 424-4129
Entity
Organization
Contact information
Practice address
1907 ANN ST, PARKERSBURG, WV 26101-2504
(304) 424-4205
(304) 424-4485
Mailing address
1907 ANN ST, PARKERSBURG, WV 26101-2504
(304) 424-4205
(304) 424-4485
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01272
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001030900
—
WV
01
—
001710672
BLUE CROSS/BLUE SHIELD
—
05
—
2002102
—
OH
01
—
CD5906
RAILROAD MEDICARE
—
Enumeration date
05/20/2006
Last updated
04/29/2008
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