Braddock Medical Group P.a., NPI 1104962729
Adult Medicine Physician in Fort Ashby, WV, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1104962729
NPI Entity Type Organization
Provider Name Braddock Medical Group P.a.
Other Name
Subpart of Organization Braddock Medical Group Pa
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Provider Location Address 70 Presidents Street, Unit 1150, Fort Ashby, WV, US
Provider Mailing Address 70 Presidents Street, Fort Ashby, WV, US, 267191150
Is Sole Proprietor? No
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Organization Official

Official Name DR. MD Paul Taylor Livengood
Official Position OWNER
Phone 304-298-3605

Group Taxonomy

Taxonomy Code 193400000X
Taxonomy Name 193400000X SINGLE SPECIALTY GROUP
Definition A business group of one or more individual practitioners, all of who practice with the same area of specialization.

Primary Taxonomy

Taxonomy Code

207QA0505X

Taxonomy Name Adult Medicine Physician
Classification

Family Medicine

Group

Allopathic & Osteopathic Physicians

License No. 11172
License State WV
Description Definition to come.

Other Organization Name

Fort Ashby Family Practice
Other Name

Business Address

Braddock Medical Group P.a.
70 Presidents Street
Unit 1150

Fort Ashby, WV, US

Phone: 304-298-3605
Fax: 304-298-3578

Mailing Address

Braddock Medical Group P.a.
70 Presidents Street
Fort Ashby, WV, US
ZIP 267191150
Phone: 304-298-3605
Fax: 304-298-3578

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
850-290 MAMSI MDIPA OPTIMUM 01
H529BR MD BCBS GROUP # 01
W399 BCBS FEDERAL PROVIDER # 01
00716943 WV BCBS PROVIDER # 01
41707101 MD BCBS PROVIDER # 01
3810000010 WV MEDICAID 05
0003 BCBS FEDERAL GROUP # 01
0056043000 WV MEDICAID 05

Other Providers in WV, US

NPI Name Taxonomy Address

1255056628

Jennifer Knight

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829 Fairmont Rd

Morgantown, WV

1154046514

MR. Wayne Matthew Bachelor

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1730804188

Melissa Jones

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Charleston, WV

1114642568

Gideon Mossor

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200 Association Dr Ste 130

Charleston, WV

1982329330

Tanisha Wilson

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1164147500

Deloris Ann Hopkins

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1255056693

Elizabeth Neal

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Luke Petrice

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1588389910

Joshua Riley

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1992420319

Karie Morrison

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1275258691

Katelyn Lucas

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Princeton, WV

1558086975

Jenna Taylor

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Huntington, WV

1740905165

Tisean Jayree Walker

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Huntington, WV

1922723345

Montana Wallace

Individual

Personal Care Attendant

10 6th Ave W

Huntington, WV

1033834452

Natasha Sharon Sexton

Individual

Personal Care Attendant

400 Bluefield St Lot 16

Wayne, WV

1770208191

Katheryn Joyce Bailey

Individual

Personal Care Attendant

1236 Madison Ave

Huntington, WV

1518682939

Alexis Perry

Individual

Personal Care Attendant

712 Mercer St Ste D

Princeton, WV

1174248587

Stevie Dawn Cline

Individual

Personal Care Attendant

695 Mountaineer Hwy

Mullens, WV

1003531419

Britney Brogan

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School Registered Nurse

267 Midway Rd

Alum Creek, WV

1689399099

Mary Mccullough

Individual

Personal Care Attendant

1599 2nd Ave

Charleston, WV

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