Organization
PRESTIGE PRIMARY CARE ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANKLIN SCOTT MOORE D.O. (OWNER)
(304) 768-0700
Entity
Organization
Contact information
Practice address
4501 MACCORKLE AVE SW, SUITE 301, SOUTH CHARLESTON, WV 25309-1444
(304) 768-0700
(304) 768-9790
Mailing address
4501 MACCORKLE AVE SW, SUITE 301, SOUTH CHARLESTON, WV 25309-1444
(304) 768-0700
(304) 768-9790
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1212
WV
207R00000X
Internal Medicine Physician
1390
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810007578
—
WV
Enumeration date
03/15/2007
Last updated
10/16/2007
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