MOUNTAIN STATE MEDICAL SPECIALTIES, PLLC
NPI 1891892097
Dermatology in Bridgeport, WV

Active since September 20, 2006
120 MEDICAL PARK DR, SUITE 200, BRIDGEPORT, WV 26330(304) 624-7200(304) 554-0413 Get Directions Write a Review

NPPES record last updated: March 14, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 14, 2025, Jul 18, 2019 (2 updates tracked since 2019).

About Mountain State Medical Specialties, Pllc NPPES

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

MOUNTAIN STATE MEDICAL SPECIALTIES, PLLC (NPI 1891892097) is a healthcare organization registered as a dermatology in Bridgeport, West Virginia and active in the NPI registry since September 2006. The organization lists Eugene Brent Kirkland, Cmo, as its authorized official.

NPPES Registry Identity

NPI1891892097
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameMOUNTAIN STATE MEDICAL SPECIALTIES, PLLC
Location Address120 MEDICAL PARK DR, SUITE 200Bridgeport, WV 26330-9012
Mailing AddressPo Box 746750Atlanta, GA 30374-6750 · (866) 680-8505 · Fax (937) 436-4156
Fax(304) 554-0413
Organization SubpartNo
Authorized OfficialEugene Brent KirklandCmo · (513) 701-5526
Enumeration DateSeptember 20, 2006
Last NPPES UpdateMarch 14, 20252 updates tracked since enumeration
NPPES CertifiedMarch 14, 2025
NPI 1891892097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedAllergy & ImmunologyTaxonomy 207K00000X
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedInternal Medicine · RheumatologyTaxonomy 207RR0500X
120 MEDICAL PARK DR, Bridgeport, WV 26330

Other Identifiers 1

Medicaid3810004579WV

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

Other Providers at the Same Location NPPES 17

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

Internal Medicine
120 MEDICAL PARK DR, SUITE 300
BRIDGEPORT, WV 26330
Pharmacist
120 MEDICAL PARK DR, SUITE 102
BRIDGEPORT, WV 26330
Optometrist
120 MEDICAL PARK DR, SUITE 104
BRIDGEPORT, WV 26330
Optometrist
120 MEDICAL PARK DR, SUITE 104
BRIDGEPORT, WV 26330
Dermatology
120 MEDICAL PARK DR, SUITE 200
BRIDGEPORT, WV 26330
Dermatology
120 MEDICAL PARK DR, SUITE 200
BRIDGEPORT, WV 26330
Physician Assistant
120 MEDICAL PARK DR, SUITE 200
BRIDGEPORT, WV 26330
Dermatology
120 MEDICAL PARK DR, SUITE 300
BRIDGEPORT, WV 26330

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1891892097, enumerated as an "organization" on September 20, 2006.

The provider is located at 120 MEDICAL PARK DR SUITE 200 BRIDGEPORT, WV 26330 and the phone number is (304) 624-7200.

Dermatology with taxonomy code 207N00000X.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.