Provider Demographics
NPI:1073907564
Name:DUSSEAU, BRIAN THOMAS (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:THOMAS
Last Name:DUSSEAU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3545 OLENTANGY RIVER RD STE 525
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3983
Mailing Address - Country:US
Mailing Address - Phone:614-261-1900
Mailing Address - Fax:614-261-7538
Practice Address - Street 1:3545 OLENTANGY RIVER RD STE 525
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3983
Practice Address - Country:US
Practice Address - Phone:614-261-1900
Practice Address - Fax:614-261-7538
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.0146762086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care