Provider Demographics
NPI:1518058049
Name:PANHANDLE MEDICINE OF INWOOD, PLLC
Entity Type:Organization
Organization Name:PANHANDLE MEDICINE OF INWOOD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:COLLETT
Authorized Official - Last Name:VELTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-229-7630
Mailing Address - Street 1:PO BOX 1845
Mailing Address - Street 2:
Mailing Address - City:INWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:25428-1845
Mailing Address - Country:US
Mailing Address - Phone:304-229-7630
Mailing Address - Fax:304-229-7689
Practice Address - Street 1:365 MIDDLEWAY PIKE
Practice Address - Street 2:
Practice Address - City:INWOOD
Practice Address - State:WV
Practice Address - Zip Code:25428-1845
Practice Address - Country:US
Practice Address - Phone:304-229-7630
Practice Address - Fax:304-229-7689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV54825363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty