Provider Demographics
NPI:1003228230
Name:HARMON, BRYAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:
Last Name:HARMON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 HARRODSBURG RD STE C115
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-1792
Mailing Address - Country:US
Mailing Address - Phone:859-278-8855
Mailing Address - Fax:859-278-8856
Practice Address - Street 1:1401 HARRODSBURG RD STE C115
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-1792
Practice Address - Country:US
Practice Address - Phone:859-278-8855
Practice Address - Fax:859-278-8856
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00474213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery