Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. BRIAN DOUGLASS BOURBON, CERTIFIED PEDORTHIST
ActiveMR. BRIAN DOUGLASS BOURBON, CERTIFIED PEDORTHIST is a Specialist healthcare provider located in CREVE COEUR, Missouri. NPI 1790124923 is currently active in the NPPES registry. Verify at CMS.
Specialist · CREVE COEUR, MO
Registration Details
- NPI Number
- 1790124923
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 20, 2013 (13.007483555134 yrs)
- Last Updated
- Jun 20, 2013
- License
-
CPED3999 (MO)
Practice Information
- Address
-
11709 OLD BALLAS RDSUITE 201CREVE COEUR, MO, 631417029Browse MO providers · Browse ZIP 63141
- Phone
- 3144321903
- Fax
- 3144325105
- Primary Specialty
-
Specialist
174400000X
Other Specialist Providers in CREVE COEUR, MO
| Name | Credential | NPI |
|---|---|---|
| KATHY C. MAUPIN | M.D. | 1356357867 |
| MRS. BARBARA SUE BAER | BS EDUCATION | 1568504009 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.