Provider Demographics
NPI:1558458570
Name:INGLERIGHT, BRIAN J (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:J
Last Name:INGLERIGHT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14540 CORTEZ BLVD
Mailing Address - Street 2:STE 104
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34613
Mailing Address - Country:US
Mailing Address - Phone:352-592-1243
Mailing Address - Fax:352-592-1246
Practice Address - Street 1:14540 CORTEZ BLVD
Practice Address - Street 2:STE 104
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-6056
Practice Address - Country:US
Practice Address - Phone:352-592-1243
Practice Address - Fax:352-592-1246
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS6103207Q00000X
OH34-003737207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35742ZMedicare ID - Type Unspecified
FLK9711Medicare ID - Type Unspecified
FLA15953Medicare UPIN