DR. MARSHAL T GWYNN (NPI# 1407173982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407173982 |
| Entity Type | Individual |
| Full Name | DR. MARSHAL T GWYNN |
| Credential | DPM |
| Practice Address |
401 Rogers St Princeton WV 24740-3636 |
| Mailing Address |
Po Box 365 Prosperity WV 25909-0365 |
| Practice Telephone | 3044879442 |
| Practice Fax Number | 3305360069 |
| Mailing Telephone | 3044879442 |
| Mailing Fax Number | 3305429932 |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2020-06-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 10436 | WV | Podiatric Medicine & Surgery Service Providers |
| Y | 213E00000X | Podiatrist | 0103301085 | VA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE NUMBER | VVA226A | 01 |
| Street Address |
401 ROGERS ST |
| City | PRINCETON |
| State | WV |
| Zip Code | 24740-3636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669433231 | Douglas Stewart Dockery | Podiatrist | 401 Rogers St, Princeton, WV 24740-3636 | 2006-03-31 |
| 1093166076 | Bradley Henry Hoffman | Podiatrist | 401 Rogers St, Princeton, WV 24740-3636 | 2016-06-30 |
| 1053580696 | Mark T Wilt | Podiatrist | 401 Rogers St, Princeton, WV 24740-3636 | 2008-02-28 |
| 1437189321 | Anthony P Zarra | Podiatrist | 401 Rogers St, Princeton, WV 24740-3636 | 2006-07-04 |
| 1740227909 | Foot and Ankle Clinic of The Virginias Inc | Podiatrist | 401 Rogers St, Princeton, WV 24740-3636 | 2006-05-31 |
| 1386695245 | Robert Knox | Podiatrist | 401 Rogers St, Princeton, WV 24740-3636 | 2006-05-15 |
| 1932159704 | James Louis Chianese | Podiatrist | 401 Rogers St, Princeton, WV 24740-3636 | 2006-05-11 |
| 1982667903 | Timothy John Donatelli | Podiatrist | 401 Rogers St, Princeton, WV 24740-3636 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658632 | New Beginnings Therapy Services, LLC | Community/Behavioral Health | 616 Harrison Street, Princeton, WV 24740 | 2020-10-27 |
| 1215536222 | Right At Home | Home Health | 313 Locus St, Princeton, WV 24740 | 2020-10-21 |
| 1881208098 | Robin Lane | Technician | 174 Tea Kettle Road, Princeton, WV 24740 | 2020-09-04 |
| 1134739824 | Nona Arthur | Technician | 708 Bluefiled Ave, Princeton, WV 24740 | 2020-08-06 |
| 1851909014 | Tina B Altizer | Speech-Language Pathologist | 120 12th Street, Princeton, WV 24740 | 2020-07-14 |
| 1245712504 | Tracy Jean Mitchell | Speech-Language Pathologist | 1200 Mercer St, Princeton, WV 24740 | 2018-09-04 |
| 1700305240 | Tina Six | Registered Nurse | 1403 Honaker Avenue, Princeton, WV 24740 | 2017-09-15 |
| 1013449172 | Karin Cappa | Pharmacist | 669 Cornfield Rd, Princeton, WV 24740 | 2017-03-29 |
| 1942661723 | Virginia Chryssikos | Social Worker | 3016 E Cumberland Road, Bluestone Family Practice, Bluefield, WV 24740 | 2016-03-08 |
| 1477939460 | Kathy Diane Wyrick | Counselor | 220 South Walker Street, Princeton, WV 24740 | 2015-08-03 |
| Find all providers in zip 24740 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033205950 | Joseph G Wolfe | Podiatrist | 1808 Sherman Dr Suite 2206, Princeton, IN 47670-1043 | 2006-10-05 |
| 1578672416 | Richard John Loesch | Podiatrist | 418 1/2 N Main St, Princeton, IN 47670-1516 | 2006-08-30 |
| 1669433231 | Douglas Stewart Dockery | Podiatrist | 401 Rogers St, Princeton, WV 24740-3636 | 2006-03-31 |
| 1821388539 | Sachin Patel | Podiatrist | 11 N Harrison St, Princeton, NJ 08540-3502 | 2011-04-14 |
| 1659527935 | Deaconess Clinic Inc. | Podiatrist | 685 Vail Street, Princeton, IN 47670-9510 | 2008-08-18 |
| 1053580696 | Mark T Wilt | Podiatrist | 401 Rogers St, Princeton, WV 24740-3636 | 2008-02-28 |
| 1013106533 | Healthdrive Podiatry Group, PC | Podiatrist | 103 Carnegie Ctr, Suite 300, Princeton, NJ 08540-6235 | 2007-10-22 |
| 1528256187 | Princeton Foot and Ankle Associates | Podiatrist | 11 N Harrison St, Princeton, NJ 08540-3502 | 2007-10-09 |
| 1194911651 | Princeton Orthopaedic Associates II | Podiatrist | 325 Princeton Ave, Princeton, NJ 08540-1617 | 2007-09-19 |
| 1386695245 | Robert Knox | Podiatrist | 401 Rogers St, Princeton, WV 24740-3636 | 2006-05-15 |
| Find all providers in PRINCETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.