Provider Demographics
NPI:1275610230
Name:JOHN C SHARP PHD.,D.O.
Entity Type:Organization
Organization Name:JOHN C SHARP PHD.,D.O.
Other - Org Name:POCAHONTAS MEDICAL CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-799-4645
Mailing Address - Street 1:P O BOX 320
Mailing Address - Street 2:
Mailing Address - City:MARLINTON
Mailing Address - State:WV
Mailing Address - Zip Code:24954
Mailing Address - Country:US
Mailing Address - Phone:304-456-4211
Mailing Address - Fax:304-456-5213
Practice Address - Street 1:ROUTE 92
Practice Address - Street 2:
Practice Address - City:GREEN BANK
Practice Address - State:WV
Practice Address - Zip Code:24944
Practice Address - Country:US
Practice Address - Phone:304-456-4211
Practice Address - Fax:304-456-5213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV806207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810005779Medicaid
WVJO9318702Medicare ID - Type UnspecifiedGREEN BANK LOCATION
WV3810005779Medicaid