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MEDBROOK MEDICAL ASSOCIATES INC NPI 1013960632


NPI Information

NPI: 1013960632
Provider Name: MEDBROOK MEDICAL ASSOCIATES INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1370 JOHNSON AVENUE
BRIDGEPORT, WV
ZIP 26330
Phone: (304) 842-7186
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MEDBROOK MEDICAL ASSOCIATES INC is a family medicine in Bridgeport, WV. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MEDBROOK MEDICAL ASSOCIATES INC NPI is 1013960632. The provider is registered as an organization entity type.

The provider's business location address is:

1370 JOHNSON AVENUE
BRIDGEPORT, WV
ZIP 26330-382
Phone: (304) 842-7186
Fax: (304) 842-9005

The provider's authorized official is Tim G Bugin .
The authorized official title is Vp Payor Contracting and has the following contact phone number (304) 225-2500.

The enumeration date for this NPI number is 5/17/2006 and was last updated on 2/14/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QU0200XClinic/CenterUrgent CareNo
2207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10010647002OTHERWEST VIRGINIAMEDICAID LAB
251D0925226OTHERWEST VIRGINIACLIA
30010647000MEDICAIDWEST VIRGINIA
49289141MEDICARE PINWEST VIRGINIA
501265OTHERWEST VIRGINIASTATE LICENSE
61247840001MEDICARE NSCWEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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