Medical school: JC EDWARDS SCHOOL OF MEDICINE, MARSHALL UNIVERSITY
Graduated: 1996
NPI: 1124019997
Practice Locations (2)
77 HOSPITAL DR, SUITE 401
LOGAN, WV 256013451
3047921480
PO BOX, SUITE 116
LOGAN, WV 256013451
Source: CMS National Downloadable File, September 2026.