Provider Demographics
NPI:1376899047
Name:COBLE, BRIAN GREGORY (OD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:GREGORY
Last Name:COBLE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9501 STATE AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66111-1871
Mailing Address - Country:US
Mailing Address - Phone:913-299-7200
Mailing Address - Fax:913-334-4451
Practice Address - Street 1:9501 STATE AVE STE 2
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66111-1871
Practice Address - Country:US
Practice Address - Phone:913-299-7200
Practice Address - Fax:913-334-4451
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1913152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist