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General NPI Number Information
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NPI Number | 1871825414
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Entity Type | Organization
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Legal Business Name | THOMAS E BRINEGAR P C
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Dates
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Enumeration Date | 02/08/2010
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Last Update Date | 02/08/2010
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Provider Practice Location Address
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Address Line | 112 SPRUCE ST SUITE 2
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City | BLUEFIELD
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State | VA
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Zip | 24605-1756
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Country | US
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Telephone | 276-326-3386
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Fax | 276-322-4174
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Provider Business Mailing Address
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Address Line | PO BOX 1006
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City | BLUEFIELD
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State | VA
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Zip | 24605-4006
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Country | US
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Telephone | 276-326-3386
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Fax | 276-322-4174
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS E BRINEGAR
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Credential | D.O.
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Telephone | 276-326-3386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0102036856
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License Number State | VA
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