Individual
ERIC INGERSOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 S PRESTON ST # B, RANSON, WV 25438-1628
(304) 725-7884
(304) 725-5913
Mailing address
201 S PRESTON ST # B, RANSON, WV 25438-1628
(304) 725-7884
(304) 725-5913
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
17231
WV
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001721515
BLUE CROSS/BLUE SHIELD WV
WV
05
—
0097825000
—
WV
Enumeration date
06/21/2006
Last updated
04/08/2020
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