Provider Demographics
NPI:1144261769
Name:PRICE, DAVID B (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:PRICE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-446-5289
Mailing Address - Fax:740-446-5697
Practice Address - Street 1:90 JACKSON PIKE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1560
Practice Address - Country:US
Practice Address - Phone:740-446-5289
Practice Address - Fax:740-446-5697
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-28312085R0202X
WV7222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000190817OtherUNISON MEDICAID
300028176OtherRR MEDICARE
000000006631OtherANTHEM BCBS
001714059OtherMOUNTAIN STATE BCBS
WV0121414000Medicaid
OH0512234OtherMOLINA MEDICAID
001714059OtherMOUNTAIN STATE BCBS
OH0512234OtherMOLINA MEDICAID
300028176OtherRR MEDICARE
WV0121414000Medicaid