Provider Demographics
NPI:1225122963
Name:BRITTON, GEORGE FRANK III
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:FRANK
Last Name:BRITTON
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 CUMBERLAND RD
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701
Mailing Address - Country:US
Mailing Address - Phone:304-325-3603
Mailing Address - Fax:304-325-3605
Practice Address - Street 1:3101 CUMBERLAND RD
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701
Practice Address - Country:US
Practice Address - Phone:304-325-3603
Practice Address - Fax:304-325-3605
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV767D152W00000X
VA0618000789152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001720544OtherBLUE CROSS BLUE SHIELD
VA085509OtherBLUE CROSS BLUE SHIELD
WV0150744000Medicaid
VA9205683Medicaid
WV6711560001Medicare NSC
VA085509OtherBLUE CROSS BLUE SHIELD