Organization
BRIDGEPORT EXPRESS CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY PEASAK DO (PRESIDENT)
(304) 842-3330
Entity
Organization
Contact information
Practice address
1370 JOHNSON AVE FL 1, BRIDGEPORT, WV 26330-1492
(304) 842-3330
(304) 842-3303
Mailing address
1370 JOHNSON AVE FL 1, BRIDGEPORT, WV 26330-1492
(304) 842-3330
(304) 842-3303
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810013952
—
WV
Enumeration date
12/04/2008
Last updated
01/03/2025
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