Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jack F Ditty III, MD

Individual provider Emergency Medicine Physician · NPI 1043390925

Dr. Jack F Ditty III, MD is an Emergency Medicine in Morgantown, West Virginia. Graduated from University of Kentucky College of Medicine in 2002, 24 years ago. Practices with Southeastern Emergency Physicians LLC, a 786-clinician group and accepts Medicare assignment. Licensed in West Virginia.

Years since qualifying
24
Trained at
University of Kentucky College of Medicine
Licensed in
WV
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

101 Stadium Dr
Morgantown, WV 26505
Phone: (304) 598-4000
Fax: (304) 293-6963
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 21600 (WV)

Record details

NPI number1043390925
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 16, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolUNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Graduated 2002 (24 years in practice)
Group practice Southeastern Emergency Physicians Llc — 786 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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