Healthcare Provider Details

I. General information

NPI: 1477586238
Provider Name (Legal Business Name): GREENBRIER INTEGRATED MEDICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 W RIVERSIDE ST
COVINGTON VA
24426-0916
US

IV. Provider business mailing address

PO BOX 916
COVINGTON VA
24426-0916
US

V. Phone/Fax

Practice location:
  • Phone: 540-962-8822
  • Fax: 540-962-8824
Mailing address:
  • Phone: 540-962-8822
  • Fax: 540-962-8824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES DAVID SCOTT
Title or Position: PARTNER
Credential: D.O.
Phone: 540-962-8822