Fairmont Ent Associates, Inc., NPI 1659554046
Clinic/Center in Kingwood, WV, US
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 | 1659554046 |
| NPI Entity Type | Organization |
| Provider Name | Fairmont Ent Associates, Inc. |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 300 S Price St, Kingwood, WV, US |
| Provider Mailing Address | 1712 Locust Ave, Fairmont, WV, US, 265541321 |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | DR. M.D. Joedy L Daristotle |
| Official Position | PHYSICIAN |
| Phone | 304-366-6157 |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Clinic/Center |
| Classification | |
| Group | |
| License No. | WV14772 |
| License State | WV |
| Description | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 0041418000 | WV | MEDICAID | 05 |
| CL6325 | WV | RR MEDICARE | 01 |
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