Organization
STONEWALL JACKSON MEMORIAL HOSPITAL
Active
Organization
STONEWALL JACKSON MEMORIAL HOSPITAL
Active
Other names
Weston Orthopedic and Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID D SHAFFER (ADMINISTRATOR)
(304) 269-8000
Entity
Organization
Contact information
Practice address
29 HOSPITAL PLZ, SUITE C, WESTON, WV 26452-8470
(304) 269-4431
(304) 269-9803
Mailing address
230 HOSPITAL PLZ, WESTON, WV 26452-8558
(304) 269-8000
(304) 269-8090
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
14011
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001417002
—
WV
Enumeration date
06/19/2008
Last updated
06/26/2008
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