Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 04-38221 | KS |
N | 207L00000X | Anesthesiologist | 125058375 | IL |
Y | 207L00000X | Anesthesiologist | 2015022430 | MO |
NPI | 1013238674 |
---|---|
Provider Name | Dr. Jeffrey W Brennan |
First Address | Overland Park, KS 66210-2144 |
Second Address | Kansas City, MO 64132-1136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2010 |
Last Update Date | 25/08/2015 |