Individual
KEVIN PAISLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 HOSPITAL RD, BROOKVILLE, PA 15825-1367
(814) 849-1471
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-4200
(814) 375-4232
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD066686L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001815440
—
PA
01
—
747030
PTAN
PA
Enumeration date
01/20/2006
Last updated
11/10/2020
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