Individual provider · Type 1 NPI
Victoria Leigh Takubo, PA-C
Surgical Physician Assistant · South Charleston, WV
NPI number
1194032227
Active
Practice location
4610 Kanawha Ave SW Ste 401
South Charleston, WV 25309-1367
Fax (304) 768-1829
Mailing address
4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Other practice locations
- 4605 Maccorkle Ave SW, South Charleston, WV 25309-1311 · (304) 414-4800
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant | 363AM0700X | 01484 (WV) |
| Surgical Physician Assistant Primary | 363AS0400X | 1484 (WV) |
Surgical Physician Assistant: Definition to come...
3 other providers at this address
Other surgical physician assistant providers in South Charleston
- Geno Anthony Santangelo Jr., P.A.-CSurgical Physician Assistant South Charleston, WV NPI 1013331271
- John Wright, PA-CSurgical Physician Assistant South Charleston, WV NPI 1467876623
- Jory Christopher James Gotham, PA-CSurgical Physician Assistant South Charleston, WV NPI 1528437357
- Justin Kiel Medlin, PA-CSurgical Physician Assistant South Charleston, WV NPI 1538437629
- Kristine K. Agnew, P.A.C.Surgical Physician Assistant South Charleston, WV NPI 1639100266
- Madalynn Marie Raynor, PA-CSurgical Physician Assistant South Charleston, WV NPI 1740053222
- Timothy Ford, PA-CSurgical Physician Assistant South Charleston, WV NPI 1750709226
- Mark Edward Javins, PA-CSurgical Physician Assistant South Charleston, WV NPI 1780112557
About NPI 1194032227
Victoria Leigh Takubo, PA-C's National Provider Identifier is 1194032227, issued on Sep 10, 2010. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in South Charleston, WV. The record was last updated on Jan 4, 2022.