Braddock Medical Group PA
Braddock Medical Group PA is an Adult Medicine Physician in Fort Ashby, West Virginia. Licensed in West Virginia. Registered with an NPI since 2007.
- Licensed in
- WV
- In the registry since
- 2007
What do these letters mean?
- PA — Professional association
- A form of business registration, not a clinical qualification.
Practice location Address checks out
70 Presidents St Unit 1150Fort Ashby, WV 26719-1150
Phone: (304) 298-3605
Fax: (304) 298-3578
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Adult Medicine Physician (primary) | Taxonomy 207QA0505X · Licence 11172 (WV) |
|---|
Record details
| NPI number | 1104962729 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Braddock Medical Group PA |
| Authorized official | Paul Livengood — Owner · (304) 298-3605 |
| Other names | Fort Ashby Family Practice |
| NPI enumerated | January 30, 2007 |
| Last updated in NPPES | November 1, 2016 |
| Mailing address | 70 Presidents Street, Fort Ashby, WV 26719-1150 |