NPIMap

Organization Active NPI

Psychconsultmd

  • Psychiatry Physician
  • Lewisburg, WV
National Provider Identifier
1114003084
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
21057 Issued in WV
Legal business name
PSYCHCONSULTMD
Practice address
206 Skylar Dr
Lewisburg, WV 24901
Phone
(336) 978-4618
NPI assigned
Oct 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Douglas Ray Eitel, MD
Title
Physician
Phone
(336) 978-4618

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 21057 WV Primary

Addresses

Primary practice location

206 Skylar Dr
Lewisburg, WV 24901

Mailing address

206 Skylar Dr
Lewisburg, WV 24901
Phone (336) 978-4618

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114003084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 SKYLAR DR",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "24901",
            "telephone_number": "336-978-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 SKYLAR DR",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "24901",
            "telephone_number": "336-978-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHCONSULTMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EITEL",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "336-978-4618",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "21057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.