Most Relevant Information
Provider Data
| NPI Number: | 1003470469 |
| Provider Name: | RYAN AZIZ THOMAS BRICKNELL MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/30/2019 |
| Last Updated: | 03/30/2023 |
Provider Practice Location
200 E CHESTNUT ST BLDG SUITE303
LOUISVILLE
KY
402021831
Practice Location Phone/Fax
| Phone: | 5026295552 |
| Fax: | 5026293132 |
Provider Mailing Location
PO BOX 776351
CHICAGO
IL
606776351
Provider Mailing Phone/Fax
| Phone: | 5025889490 |
| Fax: | 5022725116 |