Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 19030 | WV |
N | 111NI0900X | Internist | 19030 | WV |
N | 207RG0300X | Geriatric Medicine | 19030 | WV |
NPI | 1013094119 |
---|---|
Provider Name | Joseph Jarrell |
First Address | Charleston, WV 25306-6635 |
Second Address | Charleston, WV 25301-1614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 24/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001712898 | BCBS PIN NUMBER (01) | WV |
0080847000 | (05) | WV |
G61178 | (02) | WV |