NPI 1104996776

Richard T.C. Wan, M.D. ,psc

Organisation Preferred Provider Organization Morgantown, KY

Practice location

Address: 101 W Roberts St, Morgantown, KY 42261-7942
Phone: (270) 526-3841
Fax: (270) 526-2651
Mailing address: PO Box 129, Morgantown, KY 42261-0129

Authorised official

Name: Richard Tc Wan
Title: Owner
Phone: (270) 526-3841

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 16599 (KY)

Other Preferred Provider Organization providers in Kentucky →

Registry record

NPI: 1104996776
Entity type: Organization
NPI issued: 9 Nov 2006
Record last updated: 18 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.