Dr Brandon Tyler Coburn, DDS | |
4602 Route 152, Lavalette, WV 25535-9702 | |
(304) 523-2332 | |
Not Available |
Full Name | Dr Brandon Tyler Coburn |
---|---|
Gender | Male |
Speciality | Dentist |
Location | 4602 Route 152, Lavalette, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386360527 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 4596 (West Virginia) | Primary |
Entity Name | Valley Health Systems, Inc |
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Entity Type | Part B Supplier - Public Health/welfare Agency |
Entity Identifiers | NPI Number: 1902962368 PECOS PAC ID: 9931017969 Enrollment ID: O20040325000411 |
Entity Name | Valley Health Systems, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720333461 PECOS PAC ID: 9931017969 Enrollment ID: O20130319000031 |
Entity Name | Valley Health Systems, Inc |
---|---|
Entity Type | Part B Supplier - Public Health/welfare Agency |
Entity Identifiers | NPI Number: 1548542277 PECOS PAC ID: 9931017969 Enrollment ID: O20130415000484 |
Entity Name | Valley Health Systems, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477216919 PECOS PAC ID: 9931017969 Enrollment ID: O20220602001110 |
Mailing Address | Practice Location Address |
---|---|
Dr Brandon Tyler Coburn, DDS 210 Nicole Dr, Hurricane, WV 25526-9450 Ph: (304) 687-8841 | Dr Brandon Tyler Coburn, DDS 4602 Route 152, Lavalette, WV 25535-9702 Ph: (304) 523-2332 |
Dr. Todd Michael Trimboli, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 4751 Rt 152, Lavalette, WV 25535 Phone: 304-529-2036 | |
Dr. Gary Brian Eves, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 4602 Rt 152, Lavalette, WV 25535 Phone: 304-523-2332 Fax: 304-523-0681 |