Provider Demographics
NPI:1033253091
Name:BARRY L MUNSEY, PLC
Entity Type:Organization
Organization Name:BARRY L MUNSEY, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MUNSEY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:540-851-0285
Mailing Address - Street 1:1234 MIDDLEBROOK AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-4545
Mailing Address - Country:US
Mailing Address - Phone:540-851-0285
Mailing Address - Fax:540-851-0458
Practice Address - Street 1:1234 MIDDLEBROOK AVE
Practice Address - Street 2:SUITE D
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-4545
Practice Address - Country:US
Practice Address - Phone:540-851-0285
Practice Address - Fax:540-851-0458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110840600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG52306Medicare UPIN