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General NPI Number Information
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NPI Number | 1003901018
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Entity Type | Individual
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Provider Name | WILLIAM BRYAN HARRELL MD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 615 7TH AVE
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City | BOWLING GREEN
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State | KY
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Zip | 42102
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Country | US
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Telephone | 270-783-3573
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Fax | 270-467-0226
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Provider Business Mailing Address
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Address Line | 615 7TH AVE
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City | BOWLING GREEN
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State | KY
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Zip | 42102
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Country | US
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Telephone | 270-783-4251
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Fax | 270-467-0226
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 20388
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License Number State | KY
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