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Individual

DR. JOSE Y AUDITOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
20 HOSPITAL DR, LOGAN, WV 25601-3452
(304) 831-1101
Mailing address
1431 CENTERPOINT BLVD, SUITE 100, KNOXVILLE, TN 37932-1984

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11899
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0050303001
WV
05
64065691
KY
Enumeration date
05/31/2006
Last updated
12/15/2022
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