Individual
DR. BRIAN PHILIP DEFADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1101 SAINT CHRISTOPHER DR, ASHLAND, KY 41101-7087
(606) 833-3333
(606) 833-4668
Mailing address
1101 SAINT CHRISTOPHER DR, ASHLAND, KY 41101-7087
(606) 833-3333
(606) 833-4668
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
03268
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000665202
ANTHEM BCBS
KY
05
—
3062680
—
OH
05
—
7100120830
—
KY
Enumeration date
08/06/2007
Last updated
08/26/2010
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