Provider Demographics
NPI:1780273565
Name:OPRISIU, BRIAN THOMAS
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:THOMAS
Last Name:OPRISIU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:783 E 1550TH RD
Mailing Address - Street 2:
Mailing Address - City:BALDWIN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66006-7343
Mailing Address - Country:US
Mailing Address - Phone:231-330-6988
Mailing Address - Fax:
Practice Address - Street 1:1301 SW 37TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-2308
Practice Address - Country:US
Practice Address - Phone:785-267-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-102344183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist