Individual
DR. PAUL THOMAS BRIZENDINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2305 SOUTH 65 HIGHWAY, MARSHALL, MO 65340-3702
(660) 886-7431
(660) 831-3314
Mailing address
2305 SOUTH 65 HIGHWAY, MARSHALL, MO 65340-3702
(660) 886-7431
(660) 886-9001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
15070
KY
207P00000X
Emergency Medicine Physician
Primary
30161
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054153
BCBS
KY
05
—
0125834000
—
WV
05
—
0221281
—
OH
01
—
5490
MEDICARE GROUP
KY
05
—
64150709
—
KY
01
—
930049487
RAILROAD
—
Enumeration date
01/11/2006
Last updated
08/25/2021
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