| Doctor Name: | BRIAN L WITHERS |
| NPI Number: | 1548464902 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 5101017014 |
| Business Practice Address: | 701 Hospital Loop Fairchild Afb, WA - 99011 |
| Business Phone Number: | 1509247575 |
| Business Fax Number: | |
| Mailing Address: | 701 Hospital Loop, FAIRCHILD AFB |
| State: | WA |
| Postal Code: | 99011 |
| Phone Number: | 1509247575 |
| Fax Number: | |
| NPI Enumeration Date: | 06/12/2007 |
| NPI Last Update Date: | 10/16/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5101017014 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |