Provider Demographics
NPI:1942265731
Name:BRILL, YOLANDA MUSGRAVE (MD)
Entity Type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:MUSGRAVE
Last Name:BRILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 LEADER AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-3215
Mailing Address - Country:US
Mailing Address - Phone:859-257-7910
Mailing Address - Fax:859-257-7899
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:MS137
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-5425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26698207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64266984Medicaid
0547637Medicare ID - Type Unspecified
F85125Medicare UPIN