Provider Demographics
NPI:1780995290
Name:HORNSBY, BRIAN JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JAMES
Last Name:HORNSBY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:29 HOSPITAL PLZ
Mailing Address - Street 2:SUITE B
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-8470
Mailing Address - Country:US
Mailing Address - Phone:304-269-0030
Mailing Address - Fax:304-269-0034
Practice Address - Street 1:29 HOSPITAL PLZ
Practice Address - Street 2:SUITE B
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-8470
Practice Address - Country:US
Practice Address - Phone:304-269-0030
Practice Address - Fax:304-269-0034
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34.014870207R00000X
WV2707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0274964Medicaid
WV3810025799Medicaid