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794 Virginia Ave., Welch, WV 24801 | |
(304) 436-8435 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 794 Virginia Ave., Welch, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1073656641 | NPI | - | NPPES |
3810006821 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | 1011 OD (West Virginia) | Primary |
Provider Name | Brian D Looney |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1144355140 PECOS PAC ID: 1759302599 Enrollment ID: I20120412000509 |
Mailing Address | Practice Location Address |
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Po Box 607, Welch, WV 24801-0607 Ph: (304) 436-8435 | 794 Virginia Ave., Welch, WV 24801 Ph: (304) 436-8435 |