Lori Lynn Archbold, MD

Individual provider Active NPI Pediatrics Physician · Wheeling, WV

NPI 1194721183 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1194721183
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
16808 (WV)
Practice address
30 Medical Park
Ste 200
Wheeling, WV 26003-6391
Phone
(304) 243-8808
Fax
(304) 243-5113
NPI assigned
Jun 23, 2005
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 16808 WV Yes

Addresses

Primary practice location

30 Medical Park
Ste 200
Wheeling, WV 26003-6391

Mailing address

30 Medical Park
Ste 200
Wheeling, WV 26003-6391
Phone (304) 243-8808

Other identifiers

IdentifierTypeStateIssuer
1801644000MedicaidWV

Other providers in Wheeling, WV

All providers in Wheeling, WV · Pediatrics Physician in West Virginia

Sources for this page

Verify at the official NPI Registry.