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Contact Information

JACK F DITTY III, MD
101 STADIUM DRIVE
MORGANTOWN, WV26505
 Phone: 304-598-4000
 Fax: 304-293-6963
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for JACK F DITTY III · (Male)

NPI Number 1043390925
Status Active
Credentials MD
Entity Individual
Enumeration date 10/16/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • WV License # 21600
  • WV Medicaid 3810002302
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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