Waggoner, Keith

Waggoner, Keith is an individual health care provider with primary practice located at 1824 Murdoch Ave , Parkersburg WV 26101-3230. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Waggoner, Keith can be contacted via phone (304) 424-4111.

Contact Information

Primary practice address
1824 Murdoch Ave Parkersburg WV 26101-3230
Phone: (304) 424-4111
Fax: (330) 656-5901
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 18247 West Virginia

Profile Details

NPI number 1225015050
LBN Legal business name Waggoner, Keith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Jun 12th, 2008 - about 18 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 1225015050 NPPES
West Virginia MEDICAID 0046291000
West Virginia Other 1060095
West Virginia Other 000428862
West Virginia MEDICAID 0168152

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