Individual
DR. PATRICK D. JARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
213 W MAPLE AVE, FAYETTEVILLE, WV 25840-1413
(304) 574-2833
(304) 574-2489
Mailing address
213 W MAPLE AVE, FAYETTEVILLE, WV 25840-1413
(304) 574-2833
(304) 574-2489
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3575
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1580714
UNITED CONCORDIA PROVIDER
WV
05
—
4002219000
—
WV
Enumeration date
03/05/2007
Last updated
04/24/2012
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