Medical school: JC EDWARDS SCHOOL OF MEDICINE, MARSHALL UNIVERSITY
Graduated: 1994
NPI: 1285638684
Practice Locations (2)
111 GREAT TEAYS BLVD
Scott Depot, WV 255609548
111 GREAT TEAYS BLVD
SCOTT DEPOT, WV 255609548
3047571907
Source: CMS National Downloadable File, September 2026.