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Fayette Clinic, Pllc

Fayette Clinic, Pllc is a health care provider in Lochgelly, WV. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 1 Physicians Plaza, Lochgelly, WV 25866, US
Practice Location Phone304-469-3334
Practice Location Fax
Legal Business NameFAYETTE CLINIC, PLLC
NPI ?1851580468
Entity TypeOrganization
Enumeration Date ? Oct 19, 2007
Last Update Date ? Jun 5, 2008
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Fayette Clinic, Pllc

SpecialtySpecializationLicenseLicense State
Family Medicine West Virginia
Nurse Practitioner West Virginia

legacy-id-icon Legacy Provider IDs of Fayette Clinic, Pllc

Provider IdIssuer StateIssuer TypeIssuer
0206041000West VirginiaMedicaid
200164West VirginiaOtherFEDERAL BLACK LUNG
0206041003West VirginiaMedicaid
001708474West VirginiaOtherBC/BS
513906West VirginiaOtherRURAL HEALTH PROVIDER #

official-icon Authorized Official of Fayette Clinic, Pllc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Fayette Clinic, Pllc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Ms. Darlene Newell (RN)
Authorized Official Title/PositionOFFICE MANAGER
Authorized Official Phone Number304-469-3334