Individual
BARRY DODD MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(434) 517-3123
Mailing address
422 HAMILTON BLVD, SOUTH BOSTON, VA 24592-5200
(434) 572-4074
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002391
VA
363AM0700X
Medical Physician Assistant
0110002391
VA
Other
Enumeration date
09/27/2006
Last updated
09/11/2023
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