Provider Demographics
NPI:1912420969
Name:GATEWAY ENT & ALLERGY, INC
Entity Type:Organization
Organization Name:GATEWAY ENT & ALLERGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BILLIE JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRIGGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-254-8272
Mailing Address - Street 1:PO BOX 564
Mailing Address - Street 2:
Mailing Address - City:MABSCOTT
Mailing Address - State:WV
Mailing Address - Zip Code:25871-0564
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:304-250-9697
Practice Address - Street 1:240 GEORGE ST
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2641
Practice Address - Country:US
Practice Address - Phone:304-254-8272
Practice Address - Fax:304-254-8280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-21
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Multi-Specialty
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Multi-Specialty