Individual
BRYAN A. SHOUSE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 PHYSICIANS PARK, FRANKFORT, KY 40601-4107
(502) 223-7629
(502) 223-9829
Mailing address
1 PHYSICIANS PARK, FRANKFORT, KY 40601-4107
(502) 223-7629
(502) 223-9829
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
39886
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000109039
ANTHEM PIN
KY
01
—
17-00426
UNITED HEALTHCARE
KY
05
—
64017320
—
KY
01
—
H19838
BLUEGRASS FAMILY HEALTH
KY
Enumeration date
05/24/2006
Last updated
07/09/2007
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