Brian Russell Balcolm, IDMT
Individual provider Active NPI Independent Duty Medical Technicians · McConnell Afb, KS
NPI 1205110368 · NPPES record last updated Jul 10, 2023
Key facts
- NPI
- 1205110368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Medical Technicians 1710I1003X
- Practice address
- 57950 Leavenworth St
McConnell Afb, KS 67221-3505 - Phone
- (316) 759-6300
- NPI assigned
- Oct 6, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | Yes |
Addresses
Primary practice location
57950 Leavenworth St
McConnell Afb, KS 67221-3505
Mailing address
57950 Leavenworth St
McConnell Afb, KS 67221-3505
Phone (316) 759-3600
Other providers in McConnell Afb, KS
- 22D Medgrp-McConnell
- Johnson Acopan Jr.
- David A Alcindor
- Michelle Renee Alders
- Natalie Dawn Ashmore
- Diane Sue Bidwell
- Marilyn R Brandt
- Kent Taylor Broberg
- Annie Larae Carroll
- Cameron Scott Carson
All providers in McConnell Afb, KS · Independent Duty Medical Technicians in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.