Provider Demographics
NPI:1245624337
Name:ATIK, JANA (DPM)
Entity type:Individual
Prefix:DR
First Name:JANA
Middle Name:
Last Name:ATIK
Suffix:
Gender:F
Credentials:DPM
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 8040
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-8040
Mailing Address - Country:US
Mailing Address - Phone:304-598-4646
Mailing Address - Fax:304-598-4649
Practice Address - Street 1:1600 MURDOCH AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3248
Practice Address - Country:US
Practice Address - Phone:304-485-8040
Practice Address - Fax:304-485-4883
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-26
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4007213ES0103X
WV10465213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery