Organization Active NPI

Raleigh Pathology Resources Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Beckley, WV
National Provider Identifier
1407040827
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
RALEIGH PATHOLOGY RESOURCES INC
Practice address
1710 Harper Rd
Beckley, WV 25801-3357
Phone
(304) 256-4157
NPI assigned
Aug 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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

Authorized official

Name
Dr. Sukjung Gerald Koh, MD
Title
Medical Director
Phone
(304) 256-4157

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X WV Primary

Addresses

Primary practice location

1710 Harper Rd
Beckley, WV 25801-3357

Mailing address

39 Fox Sparrow Rd
Beckley, WV 25801-3687
Phone (304) 256-4157

Other identifiers 1

IdentifierTypeStateIssuer
0204127000MedicaidWV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1407040827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 FOX SPARROW RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013687",
            "telephone_number": "304-256-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 HARPER RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013357",
            "telephone_number": "304-256-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH PATHOLOGY RESOURCES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "KOH",
        "authorized_official_first_name": "SUKJUNG",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "304-256-4157",
        "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": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0204127000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.