Braddock Medical Group P.a.
NPI #1104962729 in Fort Ashby, West Virginia
Provider Information
- NPI Number
- 1104962729
- Entity Type
- Organization
- Organization Name
- Braddock Medical Group P.a.
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- BRADDOCK MEDICAL GROUP PA
- Primary Specialty
- Family Medicine - Adult Medicine
- Enumeration Date
- Jan 30, 2007
- Last Updated
- Nov 1, 2016
Practice Location
- Address
- 70 PRESIDENTS STREET
- Address 2
- UNIT 1150
- City
- Fort Ashby
- State
- West Virginia
- ZIP Code
- 26719-1150
- Phone
- (304) 298-3605
Authorized Official
- Name
- DR. PAUL TAYLOR LIVENGOOD, MD
- Title
- OWNER
- Phone
- (304) 298-3605
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine - Adult Medicine — Adult Medicine |
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