NPI: 1003800442 · CHARLESTON, WV 25301 · Plastic Surgery Physician · NPI assigned 08/31/2005
| Authorized Official | JACKSON, THEODORE (PRESIDENT) |
| NPI Enumeration Date | 08/31/2005 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 15 | $429.48 |
| 2023 | 14 | $467.38 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 29 | 26 | $896.86 |