Individual
DR. KEVIN L EGGLESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4619 KANAWHA AVE., SW, SOUTH CHARLESTON, WV 25309
(304) 400-4545
(304) 400-4546
Mailing address
4619 KANAWHA AVE., SW, SOUTH CHARLESTON, WV 25309
(304) 400-4545
(304) 400-4546
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
21056
WV
207RP1001X
Pulmonary Disease Physician
21056
WV
207RS0012X
Sleep Medicine (Internal Medicine) Physician
21056
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810009299
—
WV
05
—
7617007
—
NC
Enumeration date
05/02/2007
Last updated
03/16/2021
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