Individual
WILLIAM JEFFREY EARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
800 GRAND CENTRAL MALL STE 11, VIENNA, WV 26105-4100
(304) 916-1270
(304) 916-1705
Mailing address
800 GRAND CENTRAL MALL, VIENNA, WV 26105-4100
(304) 916-1270
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
340040000
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0620331
—
OH
01
—
P00314908
RAILROAD MEDICARE
OH
Enumeration date
08/13/2006
Last updated
12/20/2013
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