Basic Information
| Provider Information | |||||||||
| NPI: | 1437610474 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KERLEY | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5200 COMMERCE CROSSINGS DR FL 3 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402292182 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022534924 | ||||||||
| FaxNumber: | 5024895750 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 EASTERN BYP | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | KY | ||||||||
| PostalCode: | 404752751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8596253603 | ||||||||
| FaxNumber: | 8596253757 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2019 | ||||||||
| LastUpdateDate: | 08/11/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 05250 | KY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.