Provider Demographics
NPI:1295758480
Name:ASSALEY, JOSEPH PHILLIP (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PHILLIP
Last Name:ASSALEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 HAL GREER BLVD
Mailing Address - Street 2:ATTN: TAMMIE SILVA
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3800
Mailing Address - Country:US
Mailing Address - Phone:304-522-3420
Mailing Address - Fax:304-529-4645
Practice Address - Street 1:1660 12TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3833
Practice Address - Country:US
Practice Address - Phone:304-522-3420
Practice Address - Fax:304-529-4645
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.130812207V00000X
WV17008207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64699010Medicaid
WV0092463000Medicaid
OH0204119Medicaid
WVWV2705AOtherMEDICARE - CABELL HUNTINGTON HOSPITAL
WVWV2705AOtherMEDICARE - CABELL HUNTINGTON HOSPITAL