Berry, Thomas K
Berry, Thomas K is an sole proprietor health care provider with primary practice located at 314 Fairy Street Ext Ste B, Martinsville VA 24112-1913. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Berry, Thomas K can be contacted via phone (276) 634-5003.Contact Information
Primary practice address
314 Fairy Street Ext Ste B
Martinsville VA 24112-1913
Phone: (276) 634-5003
Fax: (276) 634-5017
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 0101042317 | Virginia |
Profile Details
| NPI number | 1073501383 |
|---|---|
| LBN Legal business name | Berry, Thomas K |
| Credentials | MD PC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 11th, 2005 |
| Last updated | Dec 11th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073501383 | NPPES |
| Virginia | Other | 10381172 | CAQH |
| Virginia | MEDICAID | 7300018 | CAQH |
| Virginia | Other | 5297564 | CAQH |
| Virginia | Other | 216612 | CAQH |
| Virginia | Other | C08438 | CAQH |
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