Individual
DR. JOSEPH W BROOKRESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1003 SUSHRUTA DR, MARTINSBURG, WV 25401
(304) 263-3367
(304) 263-1634
Mailing address
396 THATCHER RD, MARTINSBURG, WV 25403
(304) 263-2823
(304) 263-1634
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2434
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136323000
—
WV
01
—
138410
UNITED CONCORDIA
WV
01
—
140435
ANTHEM BCBS
VA
Enumeration date
08/30/2006
Last updated
07/08/2007
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