| Four Seasons Family Practice | |
|
904 Harrison St Princeton WV 24740-3011 | |
| (304) 431-7100 | |
| (304) 431-7112 |
| Full Name | Four Seasons Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 904 Harrison St, Princeton, West Virginia |
| Authorized Official Name and Position | Nancy A Lohuis (PHYSICIAN/OWNER) |
| Authorized Official Contact | 3044317100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Seasons Family Practice Po Box 1050 Princeton WV 24740-1050 Ph: (304) 431-7100 | Four Seasons Family Practice 904 Harrison St Princeton WV 24740-3011 Ph: (304) 431-7100 |
| NPI Number | 1750497145 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750497145 | NPI | - | NPPES |
| 0053383000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 16854 (West Virginia) | Primary |
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