| Richard E Vasicek | |
|
60 Roxbury Road White Hall WV 26554-3430 | |
| (304) 363-6600 | |
| (304) 363-7700 |
| Full Name | Richard E Vasicek |
|---|---|
| Speciality | Family Medicine |
| Location | 60 Roxbury Road, White Hall, West Virginia |
| Authorized Official Name and Position | Richard E Vasicek (MEMBER SINGLE OWNER) |
| Authorized Official Contact | 3043636600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard E Vasicek 60 Roxbury Road White Hall WV 26554-3430 Ph: (304) 363-6600 | Richard E Vasicek 60 Roxbury Road White Hall WV 26554-3430 Ph: (304) 363-6600 |
| NPI Number | 1659585263 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659585263 | NPI | - | NPPES |
| 3810006289 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5100942930 (West Virginia) | Primary |
Uhc-whitehall Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 177 Middletown Rd Ste 1, White Hall, WV 26554 Phone: 304-363-6600 Fax: 304-333-5201 |