SOUTHERN WV ENT
NPI 1497103386
Otolaryngology in Lewisburg, WV

Q: What is Southern Wv Medical And Surgical Specialists PLLC's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Active since June 01, 2016CLIA 51D2132903 · Waiver

206 SKYLAR DR, LEWISBURG, WV 24901(681) 318-3540(877) 712-1319 Get Directions Write a Review

NPPES record last updated: June 22, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Southern Wv Ent NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN WV ENT (NPI 1497103386) is a healthcare organization registered as an otolaryngology in Lewisburg, West Virginia and active in the NPI registry since June 2016. The organization holds a CLIA Waiver certificate valid through June 28, 2027 and lists Justin Wayne Douglas, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1497103386

Entity TypeOrganization

Primary Taxonomy207Y00000X

Legal Business NameSOUTHERN WV MEDICAL AND SURGICAL SPECIALISTS PLLC

Location Address206 SKYLAR DRLewisburg, WV 24901-9383

Mailing AddressPo Box 5482Beckley, WV 25801-7506 · (304) 929-6930 · Fax (304) 929-6935

Phone(681) 318-3540

Fax(877) 712-1319

Organization SubpartNo

Authorized OfficialJustin Wayne DouglasOwner/president · (304) 929-6930

Enumeration DateJune 1, 2016

Last NPPES UpdateJune 22, 2016

✔ NPI 1497103386 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in WV · 23770

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

206 SKYLAR DR, Lewisburg, WV 24901

Open in Google Maps ↗

Other Names 1

Doing Business AsSouthern Wv Ent

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield West Virginia.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 51D2132903

Southern Wv Medical And Surgical Specialists, PLLC · Lewisburg, WV

Active · expires Jun 28, 2027

CLIA Number51D2132903

Laboratory TypePhysician Office

Certificate Effective DateJune 29, 2025

Certificate Expiration DateJune 28, 2027

Laboratory DirectorDr. Jillian L. Douglas

Laboratory Phone(681) 318-3540

Laboratory LocationSouthern Wv Medical And Surgical Specialists, PLLC206 Skylar Drive, Lewisburg, WV 24901

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PSYCHCONSULTMD

Psychiatry & Neurology (Psychiatry)