Provider Demographics
NPI:1124019880
Name:JAMESON, STEVEN K (DO)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:K
Last Name:JAMESON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 590
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:WV
Mailing Address - Zip Code:24983-0590
Mailing Address - Country:US
Mailing Address - Phone:304-772-3064
Mailing Address - Fax:304-772-3296
Practice Address - Street 1:200 HEALTH CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:WV
Practice Address - Zip Code:24983-0000
Practice Address - Country:US
Practice Address - Phone:304-772-3064
Practice Address - Fax:304-772-3296
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1473207Q00000X
VA0102202969207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1039647OtherW COMP
WV000071943OtherBC
WV0054247000Medicaid
WVP00160909OtherRR MCARE
WVG09264Medicare UPIN
WV000071943OtherBC