MIDTOWNE FAMILY PRACTICE PLLC NPI 1154436004

NPI Information

  • NPI: 1154436004
  • Provider Name: MIDTOWNE FAMILY PRACTICE PLLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 51D0997055
  • Address: 403 12TH STREET EXT
    PRINCETON, WV
    ZIP 24740
  • Phone: (304) 431-9998

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NPI Details

MIDTOWNE FAMILY PRACTICE PLLC is a family medicine in Princeton, WV. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MIDTOWNE FAMILY PRACTICE PLLC NPI is 1154436004. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

403 12TH STREET EXT
PRINCETON, WV
ZIP 24740-300
Phone: (304) 431-9998
Fax: (304) 425-0782

The provider's authorized official is Pamela P. Faulkner .
The authorized official title is Physician/owner and has the following contact phone number (304) 431-7100.

The CLIA number assigned to this NPI record is 51D0997055 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/20/2006 and was last updated on 4/15/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine1040WEST VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10051816000MEDICAIDWEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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