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Individual
BRYAN C DAVIS
Active
Individual
BRYAN C DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-27652
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100327700C
—
KS
01
—
130330
BC/BS OF KANSAS
KS
01
—
336640
FIRSTGUARD INSURANCE
KS
Enumeration date
08/18/2006
Last updated
08/29/2011
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