Organization
WV SPINE AND PAIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WEIXING WILLIAM GUO M.D. (PRESIDENT)
(304) 561-7879
Entity
Organization
Contact information
Practice address
314 GOFF MOUNTAIN RD, SUITE 16, CROSS LANES, WV 25313-6602
(304) 561-7879
(304) 307-6619
Mailing address
PO BOX 58125, CHARLESTON, WV 25358-0125
(304) 561-7879
(304) 307-6619
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
20962
WV
208VP0014X
Interventional Pain Medicine Physician
Primary
20962
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810000903
—
WV
Enumeration date
08/22/2007
Last updated
08/22/2007
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