Organization
BURNSVILLE MEDICAL CENTER PLLC
Active
Organization
BURNSVILLE MEDICAL CENTER PLLC
Active
Other names
Braxton Primary Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTOINE KATINY MD (OWNER)
(304) 853-2278
Entity
Organization
Contact information
Practice address
110 MUNICIPAL STREET, BURNSVILLE, WV 26335-0424
(304) 853-2278
(304) 853-2520
Mailing address
110 MUNICIPAL STREET, PO BOX 424, BURNSVILLE, WV 26335-0424
(304) 853-2278
(304) 853-2520
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17332
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0034771000
—
WV
05
—
0075944000
—
WV
Enumeration date
04/06/2007
Last updated
10/05/2010
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