Provider Demographics
NPI:1558483511
Name:BREWINGTON, RICHARD RYAN (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:RYAN
Last Name:BREWINGTON
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 1:4438 N SIENNA RDG
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:MO
Mailing Address - Zip Code:64150-9503
Mailing Address - Country:US
Mailing Address - Phone:816-503-6244
Mailing Address - Fax:816-503-6244
Practice Address - Street 1:2600 E 12TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64127-1321
Practice Address - Country:US
Practice Address - Phone:816-965-1100
Practice Address - Fax:816-965-1140
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04329682084P0800X
MO20190245112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry