Individual
DR. BRIAN ROBERT CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1300 BROADWAY, MARYSVILLE, KS 66508-1821
(785) 562-5111
(785) 562-1050
Mailing address
2800 SW WANAMAKER RD, SUITE 192, TOPEKA, KS 66614-4293
(785) 272-0707
(785) 271-1512
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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