Beanblossom, Brian T

Beanblossom, Brian T is an individual health care provider with primary practice located at 6420 Dutchmans Pkwy Suite 200, Louisville KY 40205-3372. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Beanblossom, Brian T can be contacted via phone (502) 891-8300.

Contact Information

Primary practice address
6420 Dutchmans Pkwy Suite 200 Louisville KY 40205-3372
Phone: (502) 891-8300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 28243 Kentucky

Profile Details

NPI number 1548298433
LBN Legal business name Beanblossom, Brian T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Jan 12th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548298433 NPPES
Kentucky Other 000000693025 ANTHEM - NCVA
Kentucky MEDICAID 200080790A ANTHEM - NCVA
Kentucky Other P00889586 ANTHEM - NCVA
Kentucky Other 1056108 ANTHEM - NCVA
Kentucky MEDICAID 64282437 ANTHEM - NCVA
Kentucky Other 000057058X ANTHEM - NCVA

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