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NPI Code Detail

MEDICARE: BRENT WILLIAM ROBERT WEBB

MEDICARE: BRENT WILLIAM ROBERT WEBB
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1982440160
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENT WILLIAM ROBERT WEBB
Provider Business Mailing Address
First Line : 80 GETTYSBURG SQUARE RD APT 74
Second Line :
City : FORT THOMAS
State : KY
Zip : 41075-1455
Country : US
Telephone Number : 812-577-7218
Fax Number :
Provider Business Practice Location Address
First Line : 1 LOUIE B NUNN DR
Second Line :
City : HIGHLAND HEIGHTS
State : KY
Zip : 41099-9993
Country : US
Telephone Number : 812-577-7218
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2024
Last Update Date : 07/08/2024

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Directions to “ BRENT WILLIAM ROBERT WEBB ” Practice Location

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