Petersen, Judy Jones
Petersen, Judy Jones is an individual health care provider with primary practice located at 600 Morris St Suite 103, Charleston WV 25301-1409. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Petersen, Judy Jones can be contacted via phone (304) 388-7040.Contact Information
Primary practice address
600 Morris St Suite 103
Charleston WV 25301-1409
Phone: (304) 388-7040
Fax: (304) 388-7041
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 1108 | West Virginia |
Profile Details
| NPI number | 1023251840 |
|---|---|
| LBN Legal business name | Petersen, Judy Jones |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 8th, 2009 |
| Last updated | Sep 6th, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023251840 | NPPES |
| West Virginia | Other | P0106337 | MEDICARE RAILROAD |
| West Virginia | MEDICAID | 0041503000 | MEDICARE RAILROAD |
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