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Organization

TONI GOODYKOONTZ, M.D., P.L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
M GAIL DAVIS (OFFICE MANAGER/PARTNER)
(304) 622-8511
Entity
Organization

Contact information

Practice address
1514 BUCKHANNON PIKE, NUTTER FORT, WV 26301-4410
(304) 622-8511
(304) 622-8542
Mailing address
1514 BUCKHANNON PIKE, NUTTER FORT, WV 26301-4410
(304) 622-8511
(304) 622-8542

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0115011000
WV
Enumeration date
10/24/2006
Last updated
08/22/2020
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