Individual
BRANDON THOMAS KIBBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404-1873
(937) 641-3477
(937) 641-5410
Mailing address
PO BOX 933432, CLEVELAND, OH 44193-0039
(937) 641-3000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
02001980
IN
207LP3000X
Pediatric Anesthesiology Physician
02001980
IN
207LP3000X
Pediatric Anesthesiology Physician
Primary
34.014194
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200313780
—
IN
05
—
2545884
—
OH
Enumeration date
05/14/2006
Last updated
10/13/2023
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