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Individual
BRYAN V FALLIS
Active
Individual
BRYAN V FALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
00258
KY
213E00000X
Podiatrist
244160
KY
213E00000X
Podiatrist
Primary
36003149
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000619072
ANTHEM
OH
05
—
2214213
—
OH
05
—
2955422
—
OH
05
—
7100096290
—
KY
05
—
80000151
—
KY
01
—
P00732469
RAILROAD MEDICARE
KY
Enumeration date
08/17/2005
Last updated
05/07/2024
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