Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME84636 | FL |
NPI | 1376587717 |
---|---|
Provider Name | Brian G Kerr |
First Address | Gainesville, FL 32607-2557 |
Second Address | Gainesville, FL 32607-2557 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 16/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13264 | BCBS FL (01) | FL |
264072400 | (05) | FL |
CI6613 | RAILROAD MEDICARE (01) | FL |
H69961 | (02) | FL |