MEDICARE: DR. BRETT JACOB DEBELE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	8791	MN

General Provider Information

NPI Number	:	1558649467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRETT JACOB DEBELE

Provider Business Mailing Address
First Line	:	1304 W LINCOLN AVE
Second Line	:
City	:	FERGUS FALLS
State	:	MN
Zip	:	56537-4818
Country	:	US
Telephone Number	:	218-998-0701
Fax Number	:

Provider Business Practice Location Address
First Line	:	1304 W LINCOLN AVE
Second Line	:
City	:	FERGUS FALLS
State	:	MN
Zip	:	56537-4818
Country	:	US
Telephone Number	:	218-998-0701
Fax Number	:	218-998-2425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2011
Last Update Date	:	05/17/2026

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