Organization
ADVANCED SPECIALTIES, P LLC
Active
Other names
Advanced Urology
Organization subpart
No
Provider details
NPI number
Authorized official
LYNNETTA FAITH PAYNE D.O. (OWNER)
(304) 461-3879
Entity
Organization
Contact information
Practice address
1717 HARPER RD, 3RD FLOOR, SUITE A, BECKLEY, WV 25801-3373
(304) 461-3879
(304) 461-3848
Mailing address
PO BOX 5417, BECKLEY, WV 25801-7505
(304) 461-3879
(304) 461-3848
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2330
WV
Other
Enumeration date
08/13/2014
Last updated
09/19/2014
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