| Antonio R Diaz Jr, MD | |
|
174 Lmah Center Rd, Logan, WV 25601-4058 | |
| (304) 792-7130 | |
| Not Available |
| Full Name | Antonio R Diaz Jr |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 174 Lmah Center Rd, Logan, West Virginia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053339135 | NPI | - | NPPES |
| 0288291 | Medicaid | OH | |
| 1493983 | Other | WV | UMWA |
| 550751751 | Other | WV | BLUE CROSS/BLUE SHIELD |
| 64940489 | Medicaid | KY | |
| 000706447 | Other | BLUE CROSS/BLUE SHIELD | |
| 0115148000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 16814 (West Virginia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Antonio R Diaz Jr, MD Po Box 176, Logan, WV 25601-0176 Ph: (304) 792-7130 | Antonio R Diaz Jr, MD 174 Lmah Center Rd, Logan, WV 25601-4058 Ph: (304) 792-7130 |
Dr. John David Justice, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: Route 10, Three Mile Curve, Logan, WV 25601 Phone: 304-792-7130 Fax: 304-792-7138 |