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General NPI Number Information
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NPI Number | 1952865255
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Entity Type | Organization
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Legal Business Name | GREENBRIER PHYSICIANS RURAL HEALTH CLINIC
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Dates
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Enumeration Date | 01/31/2019
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Last Update Date | 01/31/2019
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Provider Practice Location Address
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Address Line | 1322 MAPLEWOOD AVE
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City | RONCEVERTE
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State | WV
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Zip | 24970-8016
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Country | US
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Telephone | 304-647-1139
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Fax | 304-647-3006
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Provider Business Mailing Address
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Address Line | 1322 MAPLEWOOD AVE
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City | RONCEVERTE
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State | WV
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Zip | 24970-8016
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Country | US
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Telephone | 304-647-1139
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Fax | 304-647-3006
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN VESS
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Credential | DO
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Telephone | 304-647-1175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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