Individual
KEVIN W O'BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 S 2ND ST, LOUISVILLE, KY 40202-2862
(502) 589-3429
(502) 583-7546
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
01076508A
IN
207N00000X
Dermatology Physician
256380
NY
207N00000X
Dermatology Physician
Primary
48776
KY
207ND0101X
MOHS-Micrographic Surgery Physician
01076508A
IN
207ND0101X
MOHS-Micrographic Surgery Physician
256380
NY
207ND0101X
MOHS-Micrographic Surgery Physician
48776
KY
207NS0135X
Procedural Dermatology Physician
01076508A
IN
207NS0135X
Procedural Dermatology Physician
256380
NY
207NS0135X
Procedural Dermatology Physician
48776
KY
Other
Enumeration date
04/12/2007
Last updated
09/21/2021
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