Organization
PRESTON MEMORIAL HOSPITAL CORPORATION
Active
Other names
Hospital Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA LOCKWOOD (PRESIDENT AND CEO)
(304) 329-1400
Entity
Organization
Contact information
Practice address
150 MEMORIAL DR, KINGWOOD, WV 26537
(304) 329-1400
(304) 329-1175
Mailing address
150 MEMORIAL DR, KINGWOOD, WV 26537
(304) 329-1400
(304) 329-1175
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
56
WV
207P00000X
Emergency Medicine Physician
Primary
56
WV
207Q00000X
Family Medicine Physician
56
WV
207T00000X
Neurological Surgery Physician
56
WV
208600000X
Surgery Physician
56
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001706817
BCBS GROUP
WV
01
—
001808002
BCBS ANES GROUP
WV
05
—
0104806001
—
WV
05
—
WV17028A
—
WV
05
—
WV97818
—
WV
05
—
WV97818A
—
WV
Enumeration date
06/08/2006
Last updated
07/09/2015
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