Provider Demographics
NPI:1518122381
Name:KENKEL, BRIAN JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:JOSEPH
Last Name:KENKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY HOSPITAL DEPT OF RADIOLOGY
Mailing Address - Street 2:1 HOSPITAL DRIVE
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65212-0001
Mailing Address - Country:US
Mailing Address - Phone:573-882-7901
Mailing Address - Fax:573-884-8876
Practice Address - Street 1:UNIVERSITY HOSPITAL DEPT OF RADIOLOGY
Practice Address - Street 2:1 HOSPITAL DRIVE
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-7901
Practice Address - Fax:573-884-8876
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20080196962085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology