Korgan, Bryan Matthew

Korgan, Bryan Matthew is an individual health care provider with primary practice located at 250 Park St , Bowling Green KY 42101-1760. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Korgan, Bryan Matthew can be contacted via phone (270) 745-1000.

Contact Information

Primary practice address
250 Park St Bowling Green KY 42101-1760
Phone: (270) 745-1000
Fax: (270) 393-1913
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4562A Kentucky

Profile Details

NPI number 1619961240
LBN Legal business name Korgan, Bryan Matthew
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2005
Last updated Sep 8th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619961240 NPPES
Kentucky MEDICAID 74009606
Kentucky Other P001182348
Kentucky Other 000000352890

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