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South Harrison Family Medicine

South Harrison Family Medicine is a health care provider in Lost Creek, WV. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 2324 Hawk Highway, Lost Creek, WV 26385-9707, US
Practice Location Phone304-745-3200
Practice Location Fax304-745-4068
Legal Business NameSOUTH HARRISON FAMILY MEDICINE
NPI ?1922197573
Entity TypeOrganization
Enumeration Date ? Oct 12, 2006
Last Update Date ? Dec 5, 2011
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of South Harrison Family Medicine

SpecialtySpecializationLicenseLicense State
Family Medicine 15551West Virginia

legacy-id-icon Legacy Provider IDs of South Harrison Family Medicine

Provider IdIssuer StateIssuer TypeIssuer
0007163000West VirginiaMedicaid

official-icon Authorized Official of South Harrison Family Medicine

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

Authorized Official Dr. Jo Ann Longenecker (MD)
Authorized Official Title/PositionPRESIDENT
Authorized Official Phone Number304-745-3200