Provider Demographics
NPI:1538155205
Name:COMER, BRIAN G (DO)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:G
Last Name:COMER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1004 SE LOUIS DR
Mailing Address - Street 2:
Mailing Address - City:MULVANE
Mailing Address - State:KS
Mailing Address - Zip Code:67110-1109
Mailing Address - Country:US
Mailing Address - Phone:316-777-0176
Mailing Address - Fax:316-777-1817
Practice Address - Street 1:1004 SE LOUIS DR
Practice Address - Street 2:
Practice Address - City:MULVANE
Practice Address - State:KS
Practice Address - Zip Code:67110-1109
Practice Address - Country:US
Practice Address - Phone:316-777-0176
Practice Address - Fax:316-777-1817
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS05-31369207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00433271OtherMEDICARE RAILROAD
KSP00433271OtherMEDICARE RAILROAD