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Contact Information

JOHN P HISSOM
102 PATRICK STREET PLZ
CHARLESTON, WV25387-2444
 Phone: 304-233-3200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
 

Mental Health

101YM0800X
Indicates primary specialty

NPI Profile & details for JOHN P HISSOM · (Male)

NPI # 1225634173
Status Active
Credentials
Entity Individual
Enumeration date 12/07/2020
Last updated 12/07/2020 - About 5 years ago
Sole proprietor 1 No
Identifiers Not Available
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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