Individual
KENNETH G JUDSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2000 MON HEALTH MEDICAL PARK DR STE 2300, MORGANTOWN, WV 26505-1168
(304) 599-8802
(304) 599-5607
Mailing address
2000 MON HEALTH MEDICAL PARK DR STE 2300, MORGANTOWN, WV 26505-1168
(304) 599-8802
(304) 599-5607
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
OS010445L
PA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
2110
WV
207RC0001X
Clinical Cardiac Electrophysiology Physician
OS010445L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018530940003
—
PA
05
—
2670622
—
OH
05
—
2670622
—
WV
Enumeration date
06/12/2006
Last updated
12/22/2022
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