Provider Demographics
NPI:1124066444
Name:VANHOOSE, BRIAN J (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:J
Last Name:VANHOOSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19217 BEAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CATLETTSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41129-9230
Mailing Address - Country:US
Mailing Address - Phone:606-929-9592
Mailing Address - Fax:
Practice Address - Street 1:1000 SAINT CHRISTOPHER DR
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7034
Practice Address - Country:US
Practice Address - Phone:606-833-3333
Practice Address - Fax:260-407-8004
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY29737146D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0153195Medicaid
KY64297377Medicaid
KY0999902Medicare ID - Type Unspecified
KY64297377Medicaid