Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4785 | KY |
N | 111NI0013X | Independent Medical Examiner | 4785 | KY |
N | 111NR0200X | Radiology | 4785 | KY |
N | 213ER0200X | Radiology | 4785 | KY |
N | 111NR0400X | Rehabilitation Chiropractor | 4785 | KY |
N | 111NX0100X | Occupational Health | 4785 | KY |
NPI | 1497812267 |
---|---|
Provider Name | Dr. Brian Keith Marquez |
First Address | Louisville, KY 40241-5230 |
Second Address | Louisville, KY 40241-5230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 12/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000378306 | ANTHEM BLUE CROSS BLUE SH (01) | |
07815453 | AETNA (01) | |
11210338 | CAQH (01) | |
2448199000 | PASSPORT ADVANTAGE (01) | KY |
50007024 | PASSPORT (01) | |
611414018 | HUMANA (01) | |
6114140180003 | CIGNA HEALTH CARE (01) | |
611414018B | HUMANA (01) | |
653884 | BLUEGRASS FAMILY HEALTH (01) | |
653884 | GE WELLNESS PLAN (01) | |
653884 | MAIL HANDLERS (01) | |
653884 | UHC OF KENTUCKY (01) | |
85003135 | (05) | KY |
U95573 | (02) | KY |