Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | DPM152 | TN |
NPI | 1316931272 |
---|---|
Provider Name | Brian Norman Kiel |
First Address | Memphis, TN 38104-3641 |
Second Address | Memphis, TN 38119-0882 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 01/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00935578 | (05) | MS |
1316931272 | (05) | MO |
220570717 | (05) | AR |
3350519 | (05) | TN |
3351646 | (05) | TN |
T61062 | (02) |