Provider Demographics
NPI:1104210335
Name:DR. BRIAN HORNSBY, PLLC
Entity Type:Organization
Organization Name:DR. BRIAN HORNSBY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HORNSBY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-918-8461
Mailing Address - Street 1:PO BOX 743
Mailing Address - Street 2:
Mailing Address - City:JANE LEW
Mailing Address - State:WV
Mailing Address - Zip Code:26378-0743
Mailing Address - Country:US
Mailing Address - Phone:304-918-8461
Mailing Address - Fax:
Practice Address - Street 1:778 ELK CITY RD
Practice Address - Street 2:
Practice Address - City:JANE LEW
Practice Address - State:WV
Practice Address - Zip Code:26378-7819
Practice Address - Country:US
Practice Address - Phone:304-918-8461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty