Organization · Type 2 NPI

Mountain State Ent & Facial Plastic Surgery, Inc

Medical Specialty Clinic/Center · Beckley, WV

NPI number 1982604997 Active

Practice location

78 Brookshire Ln
Beckley, WV 25801-6765

Fax (304) 255-2343

Specialties and licenses

Taxonomy	Code	License
Medical Specialty Clinic/Center Primary	261QM2500X	006769 (WV)

Medical Specialty Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Another provider at this address

Albert James Paine Jr., MDFacial Plastic Surgery Physician Beckley, WV NPI 1760443162

Other medical specialty clinic/center providers in Beckley

See all in Beckley →

NPI record

NPI: 1982604997
Entity type: Organization (Type 2)
Issued: Aug 1, 2005
Last updated: Mar 29, 2024
Status: Active

Other names

<unavail>
Mountain State Ent · other name
Mountain State Ent and Facial Plastic Surgery · other name

Authorized official

Albert James Paine, MD
Owner; President
(304) 255-2341

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1982604997

Mountain State Ent & Facial Plastic Surgery, Inc's National Provider Identifier is 1982604997, issued on Aug 1, 2005. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in Beckley, WV. The record was last updated on Mar 29, 2024.