Individual
DR. BREWSTER A KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
930 SW ABBEY ST, NEWPORT, OR 97365-4820
(541) 265-2244
Mailing address
310 E COLLEGE DR, COLBY, KS 67701-3716
(785) 462-6184
(785) 460-1490
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0530778
KS
207Q00000X
Family Medicine Physician
Primary
DO198303
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0530778
KANSAS LICENSE
KS
01
—
103904
BLUE CROSS
KS
01
—
103981
BLUE CROSS
KS
05
—
200267690A
—
KS
Enumeration date
07/10/2006
Last updated
11/02/2020
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