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General NPI Number Information
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NPI Number | 1689946766
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Entity Type | Individual
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Provider Name | JOACHIM R BRILL M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 2525 GLENN HENDREN DR
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City | LIBERTY
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State | MO
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Zip | 64068-9625
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Country | US
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Telephone | 816-781-8180
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Fax |
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Provider Business Mailing Address
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Address Line | 901 N FOREST LN
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City | LIBERTY
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State | MO
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Zip | 64068-3362
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Country | US
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Telephone |
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Fax |
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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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 34963
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License Number State | MO
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