Individual
BRIAN BEHRENDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
160 LONDON MOUNTAIN VIEW DR, LONDON, KY 40741-6601
(606) 864-0770
(606) 864-1461
Mailing address
100 E LIBERTY ST, SUITE 800, LOUISVILLE, KY 40202-1434
(502) 315-1459
(502) 479-1425
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1195
KY
363A00000X
Physician Assistant
TC016
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100093470
—
KY
Enumeration date
05/07/2009
Last updated
03/10/2015
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