| Organization Name: | GREENBRIER PHYSICIANS, INC |
| NPI Number: | 1154442028 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN D TROUT (CLINIC ADMINISTRATOR) |
| Mailing Address: | 200 Maplewood Ave Ronceverte |
| State: | WV US |
| Postal Code: | 249701334 |
| Phone Number: | 3046471140 |
| Fax Number: | 3046473006 |
| NPI Enumeration Date: | 04/02/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246XS1301X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Spec/Tech, Cardiovascular |
| Taxonomy Specialization: | Sonography |
| Taxonomy Definition: | |