Provider Demographics
NPI:1962537589
Name:BRILEY, LAUREN CARNEY (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:CARNEY
Last Name:BRILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ELIZABETH
Other - Last Name:CARNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 950296
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0296
Mailing Address - Country:US
Mailing Address - Phone:502-893-0220
Mailing Address - Fax:502-893-0563
Practice Address - Street 1:3950 KRESGE WAY
Practice Address - Street 2:SUITE 207
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4637
Practice Address - Country:US
Practice Address - Phone:502-893-0220
Practice Address - Fax:502-893-0563
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR0999207R00000X
KY40858207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50018625OtherPASSPORT
KY7100040790Medicaid
KY7100040790Medicaid