Dr. Bose S. Mikkilineni, M.D. Facs

LBN: Dr. Bose S. Mikkilineni, M.D. Facs
Dr. Bose S. Mikkilineni, M.D. Facs is an health care organization with primary practice located at 419 Carriage Dr , Beckley WV 25801-2805. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as the primary health care specialty. Dr. Bose S. Mikkilineni, M.D. Facs can be contacted via phone (304) 253-8416, or through Mikkilineni, M.D. Facs, Bose S via phone (304) 253-8416.

Contact Information

Primary practice address
419 Carriage Dr Beckley WV 25801-2805
Phone: (304) 253-8416
Fax: (866) 461-4726
Website:
Map and Directions
Authorized official contact:
Name: Mikkilineni, M.D. Facs, Bose S Doctor of Medicine (MD)
Phone: (304) 253-8416

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X WV12282 West Virginia

Profile Details

NPI number 1124141171
LBN Legal business name Dr. Bose S. Mikkilineni, M.D. Facs
DBA Doing business as
Authorized official Mikkilineni, M.D. Facs, Bose S Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 6th, 2007
Last updated Jan 2nd, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124141171 NPPES
West Virginia MEDICAID 0128502000

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