Provider Demographics
NPI:1184628737
Name:BROWN, BARRY S (DO)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:S
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:200 POCAHONTAS TRAIL
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986-0457
Mailing Address - Country:US
Mailing Address - Phone:304-536-5030
Mailing Address - Fax:304-536-5051
Practice Address - Street 1:200 ARH LANE
Practice Address - Street 2:STE 100
Practice Address - City:LOW MOOR
Practice Address - State:VA
Practice Address - Zip Code:24457
Practice Address - Country:US
Practice Address - Phone:540-862-6710
Practice Address - Fax:540-862-7922
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01022051576207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7079548OtherAETNA
WV91622Medicaid
VA5519989OtherFIRST HEALTH
VA116856OtherANTHEM
VA241435OtherSOUTHERN HEALTH
WVW48582OtherMTN ST BCBS
VA010060231Medicaid
VA4960796OtherCIGNA
WV1064491OtherWV COMP-BRICKSTREET
VA5519989OtherFIRST HEALTH
P00105360Medicare ID - Type UnspecifiedRAILROAD MEDICARE/RRMC
VA004322W10Medicare ID - Type UnspecifiedTRAILBLAZER HEALTH/VAMC