Basic Information
| Provider Information | |||||||||
| NPI: | 1275700866 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUNTINGTON PATHOLOGY, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5620 SOUTHWYCK BLVD | ||||||||
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| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436141501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002888325 | ||||||||
| FaxNumber: | 4198665453 | ||||||||
| Practice Location | |||||||||
| Address1: | 6007 US ROUTE 60 E | ||||||||
| Address2: | SUITE 122 | ||||||||
| City: | BARBOURSVILLE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 255041042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3047331010 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2008 | ||||||||
| LastUpdateDate: | 10/10/2008 | ||||||||
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| AuthorizedOfficialLastName: | COUCH | ||||||||
| AuthorizedOfficialFirstName: | AMOS | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3047331010 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0105X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology/Laboratory Medicine |
No ID Information.