Basic Information
| Provider Information | |||||||||
| NPI: | 1225528680 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TUFTS | ||||||||
| FirstName: | LAUREN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 MEDICAL CENTER DR STE 3000 | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 257013656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046911374 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1600 MEDICAL CENTER DR STE 3000 | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 257013656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046911374 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2018 | ||||||||
| LastUpdateDate: | 04/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | WV | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208000000X | 30646 | WV | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.