Dale, Jonathan B

Dale, Jonathan B is an individual health care provider with primary practice located at 400 Fairview Heights Rd , Summersville WV 26651-9308. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Dale, Jonathan B can be contacted via phone (304) 872-2891.

Contact Information

Primary practice address
400 Fairview Heights Rd Summersville WV 26651-9308
Phone: (304) 872-2891
Fax: (304) 872-6854
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 23453 West Virginia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 23453 West Virginia

Profile Details

NPI number 1760481014
LBN Legal business name Dale, Jonathan B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Apr 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760481014 NPPES
West Virginia MEDICAID 3810014181
West Virginia Other DA7395861

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