Derrick Jason Brumfield, MPT
Individual provider Active NPI Physical Therapist · Logan, WV
NPI 1912190034 · NPPES record last updated Aug 22, 2007
Key facts
- NPI
- 1912190034
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 002504 (WV)
- Practice address
- 1000 W Park Ave
Logan, WV 25601-3155 - Phone
- (304) 752-8723
- Fax
- (304) 752-8728
- NPI assigned
- Aug 22, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002504 | WV | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 002504 | WV | Yes |
Addresses
Primary practice location
1000 W Park Ave
Logan, WV 25601-3155
Mailing address
1000 W Park Ave
Logan, WV 25601-3155
Phone (304) 752-8723
Other providers in Logan, WV
- Brianna Browning
- Jackie Browning
- Jerry Don Browning
- Katherine Browning
- Regina Mabel Browning
- Amber Bryant
- Haylie Nicole Bryant
- Kimberly Bryant
- Mary Bryant
- Teresa Bryant
All providers in Logan, WV · Physical Therapist in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.