Organization
DOMINGO G JAVIER MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOMINGO GONZALES JAVIER MD (MD)
(304) 325-5755
Entity
Organization
Contact information
Practice address
1701 JEFFERSON ST, BLUEFIELD, WV 24701-1701
(304) 325-5755
(304) 323-1639
Mailing address
1701 JEFFERSON ST, BLUEFIELD, WV 24701-1701
(304) 325-5755
(304) 323-1639
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0127512000
—
WV
01
—
0472131
UMWA-FUNDS
—
01
—
062480
B/C/ANTHEM
VA
01
—
1022384
WORKERS COMP
WV
01
—
4454937
AETNA
—
01
—
7350431
VA MED ASSIS
VA
01
—
851 945
MAMSI
—
01
—
V000267
BLACK LUNG
—
Enumeration date
09/28/2006
Last updated
08/22/2020
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