Individual
DR. BRIAN ROBERT CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1767
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200569190A
—
KS
01
—
651179
BLUE CROSS BLUE SHIELD OF KS
KS
Enumeration date
07/25/2007
Last updated
06/24/2010
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