Provider Demographics
NPI:1568522258
Name:MOUNTAINEER ORTHOPEDIC SPECIALISTS, LLC
Entity Type:Organization
Organization Name:MOUNTAINEER ORTHOPEDIC SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:POST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-594-0456
Mailing Address - Street 1:2195 CHEAT RD.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508
Mailing Address - Country:US
Mailing Address - Phone:304-594-0456
Mailing Address - Fax:888-501-6306
Practice Address - Street 1:2195 CHEAT RD.
Practice Address - Street 2:SUITE 2
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508
Practice Address - Country:US
Practice Address - Phone:304-594-0456
Practice Address - Fax:888-501-6306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV15233207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVMO9336951Medicare ID - Type UnspecifiedGROUP PRACTICE