OrganizationActive
Fairmont Ent Associates Inc
NPI 1720055882 · Otolaryngology Physician · Fairmont, WV
Provider details
- NPI number
- 1720055882
- Entity type
- Organization
- Primary specialty
- Otolaryngology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Joedy Daristotle, President(304) 366-6157
- License
- 398 (WV)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Suppliers
Practice location
1712 Locust Ave
Fairmont, WV 26554
Phone: (304) 366-6157
Fax: (304) 366-0177
Approximate (ZIP-level) locationGet directions
Mailing address
1712 Locust Ave
Fairmont, WV 26554
Registry dates
- Enumerated
- 2006-03-07
- Last updated
- 2012-10-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.