Provider Demographics
NPI:1780783670
Name:AYERS, HAROLD EDWARD JR (MD)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:EDWARD
Last Name:AYERS
Suffix:JR
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:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:PT PLEASANT
Mailing Address - State:WV
Mailing Address - Zip Code:25550-0236
Mailing Address - Country:US
Mailing Address - Phone:304-675-1020
Mailing Address - Fax:304-675-5893
Practice Address - Street 1:2520 VALLEY DR
Practice Address - Street 2:SUITE #012
Practice Address - City:PT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550-2031
Practice Address - Country:US
Practice Address - Phone:304-675-6015
Practice Address - Fax:304-675-5893
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV15579207R00000X
WV155792080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV000470415OtherBCBS
WV550737600OtherCOMMERCIAL INSURANCE
OH0710958Medicaid
WV0105937000Medicaid
WV550737600OtherCOMMERCIAL INSURANCE
WV0105937000Medicaid