Organization
KANAWHA MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOPSIE V. JAGANNATH MD (OWNER)
(304) 925-1050
Entity
Organization
Contact information
Practice address
4924 MACCORKLE AVENUE SE, CHARLESTON, WV 25304
(304) 925-1050
(304) 553-0862
Mailing address
4924 MACCORKLE AVENUE SE, CHARLESTON, WV 25304
(304) 925-1050
(304) 553-0862
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810003360
—
WV
Enumeration date
06/01/2006
Last updated
09/05/2023
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