# BRIAN KENT HEABERLIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1992730493
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | 52550 | SC | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | TMP - 01602 | WV | — |

## Other

- **Enumeration date:** 07/12/2006
- **Last updated:** 11/06/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2442280 | — | OH |
| 05 | — | 3810005836 | — | WV |
| 01 | — | P00335936 | RAILROAD | — |