Individual
JOHN E CORNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 MEDICAL CENTER DR STE G500, HUNTINGTON, WV 25701-3659
(304) 691-1787
Mailing address
1600 MEDICAL CENTER DR STE B500, HUNTINGTON, WV 25701-3655
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20419
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1812148000
—
WV
05
—
2325700
—
OH
01
—
64051147
KY MEDICAID FOR CABELL HUNTINGTON HOSPITAL
KY
05
—
64051147
—
KY
Enumeration date
03/29/2006
Last updated
01/18/2022
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