Provider Demographics
NPI:1558142265
Name:TWYMAN, RODNEY ALLEN
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:ALLEN
Last Name:TWYMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 POGUE ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-1509
Mailing Address - Country:US
Mailing Address - Phone:304-939-2192
Mailing Address - Fax:
Practice Address - Street 1:1650 8TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25703-1702
Practice Address - Country:US
Practice Address - Phone:304-962-2087
Practice Address - Fax:304-523-9084
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist