Provider Demographics
NPI:1295168979
Name:GALFORD, KERI (PA-C)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:
Last Name:GALFORD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:
Other - Last Name:RATLIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 590
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:WV
Mailing Address - Zip Code:24983-0590
Mailing Address - Country:US
Mailing Address - Phone:304-753-9100
Mailing Address - Fax:304-753-9353
Practice Address - Street 1:620 SCHOOL STREET
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:WV
Practice Address - Zip Code:24983
Practice Address - Country:US
Practice Address - Phone:304-772-4580
Practice Address - Fax:304-772-4581
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV682363AM0700X
VA0110-004341207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA491881Medicare PIN