Twin States Family Care Center
Organization Active NPI Family Medicine Physician · Wolfe, WV
NPI 1003907676 · NPPES record last updated Apr 20, 2008
Key facts
- NPI
- 1003907676
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 11738WV (WV)
- Legal business name
- TWIN STATES FAMILY CARE CENTER
- Practice address
- Highway 102
Wolfe, WV 24751 - Phone
- (304) 248-8096
- Fax
- (304) 248-8096
- NPI assigned
- Sep 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Reynaldo Jose, MD
- Title
- Owner
- Phone
- (304) 248-8096
Practitioners 1
-
Beverly L Whitt, CFNP
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 11738WV | WV | Yes |
Addresses
Primary practice location
Highway 102
Wolfe, WV 24751
Mailing address
PO Box 19
Nemours, WV 24738-0019
Phone (304) 248-8096
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0048928000 | Medicaid | WV |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.