Traylor, Jack R
Traylor, Jack R is an individual health care provider with primary practice located at 1400 Hal Greer Boulevard , Huntington WV 25701-3656. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Traylor, Jack R can be contacted via phone (304) 399-6609.Contact Information
Primary practice address
1400 Hal Greer Boulevard
Huntington WV 25701-3656
Phone: (304) 399-6609
Fax: (304) 399-6621
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 12969 | West Virginia |
Profile Details
| NPI number | 1174582456 |
|---|---|
| LBN Legal business name | Traylor, Jack R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | May 3rd, 2021 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174582456 | NPPES |
| West Virginia | MEDICAID | 0128350000 | |
| West Virginia | MEDICAID | 64694771 | |
| West Virginia | MEDICAID | 0491258 |
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