Kanawha Pathology Associates Inc

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

KANAWHA PATHOLOGY ASSOCIATES INC

Practice address

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311

Phone

(304) 766-3560

NPI assigned

Jul 20, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Robert M Fulks, MD

Title

President/Pathologist

Phone

(304) 766-3560

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1346249448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9129",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253090129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-766-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANAWHA PATHOLOGY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "FULKS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/PATHOLOGIST",
        "authorized_official_telephone_number": "304-766-3560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008272000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA0748",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige Elizabeth Justice, FNP-C
• Paulette Susan Justice, LPC, LCSW
• Caitlin Justus
• Ziad Kahwash, MD
• Kathy Kallmerten
• Kanawha Urology Associates Inc
• Kanawha Valley Gastroenterology Associates, Inc.
• Kanawha Valley Heart Specialists
• Kanawha Valley Radiologists Incorporated
• Rebecca Kanode

• Anatomic Pathology & Clinical Pathology Physician in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Anatomic Pathology & Clinical Pathology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.