Organization
PRIMARY ONCOLOGY NETWORK PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN JURJUS AZAR MD, FACP (OWNER)
(304) 366-0111
Entity
Organization
Contact information
Practice address
1325 LOCUST AVE STE 15, FAIRMONT, WV 26554-1435
(304) 366-0111
(304) 366-2099
Mailing address
PO BOX 1286, FAIRMONT, WV 26555-1286
(304) 366-0111
(304) 366-2099
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
17192
WV
332900000X
Non-Pharmacy Dispensing Site
26308
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0204568000
—
WV
01
—
CH6378
RAILROAD MEDICARE
WV
Enumeration date
05/25/2006
Last updated
11/16/2016
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