Organization
ST. MARY'S MEDICAL MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD CAMPBELL (CFO)
(304) 526-8914
Entity
Organization
Contact information
Practice address
2900 1ST AVE, HUNTINGTON, WV 25702
(304) 526-1234
(304) 526-1489
Mailing address
PO BOX 4190, BARBOURSVILLE, WV 25504-4190
(304) 908-9201
(304) 935-3334
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207VX0201X
Gynecologic Oncology Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001934200
BSMT MOUNTAIN STATE
WV
01
—
002016965
BSMT/ MID LEVEL
WV
05
—
3810007944
—
WV
01
—
3810009673
UNISYS / ST MARY'S LAB
WV
05
—
7100073660
—
KY
05
—
7100101210
—
KY
Enumeration date
01/05/2007
Last updated
08/13/2025
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