Individual
MR. THOMAS HARRY CHASE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 MEDICAL CENTER DRIVE, VETERANS HOSPITAL, CLARKSBURG, WV 26301
(304) 623-3461
(304) 623-7776
Mailing address
RR 3, BOX228, GRAFTON, WV 26354-9803
(304) 265-3117
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1003693
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003963
PA-C ERTIFICATION NUMBER
—
01
—
45721
NCC CERTIFICATION #
—
Enumeration date
04/13/2006
Last updated
07/08/2007
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