Provider Demographics
NPI:1316997943
Name:AUSTIN, BRYAN KINCAID (MD, MS)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:KINCAID
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-7802
Mailing Address - Country:US
Mailing Address - Phone:715-847-2000
Mailing Address - Fax:
Practice Address - Street 1:2000 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-7802
Practice Address - Country:US
Practice Address - Phone:715-847-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI61156-20207R00000X
MI4301512703207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN061043700Medicaid
MNQ41043Medicare UPIN
MN061043700Medicaid