Provider Demographics
NPI:1780609677
Name:HIX, CHARITY V (MD)
Entity type:Individual
Prefix:DR
First Name:CHARITY
Middle Name:V
Last Name:HIX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 KANAWHA BLVD E
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-3001
Mailing Address - Country:US
Mailing Address - Phone:304-343-4371
Mailing Address - Fax:304-353-0215
Practice Address - Street 1:1306 KANAWHA BLVD E
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-3001
Practice Address - Country:US
Practice Address - Phone:304-343-4371
Practice Address - Fax:304-353-0215
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV20725207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810005917Medicaid
WV4187701Medicare PIN
WV4187702Medicare PIN
WV3810005917Medicaid
WV4187703Medicare PIN