Individual
JOHN RUSSELL BARLEY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12200 WARWICK BLVD, SUITE 310, NEWPORT NEWS, VA 23601-2344
(757) 534-9988
(757) 534-5688
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
(757) 316-5960
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0102203634
VA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
0102203634
VA
Other
Enumeration date
06/25/2012
Last updated
11/10/2016
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