MEDICARE: BRANDON DOYLE SLUSHER ATC

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	2255A2300X	Athletic Trainer	AT865	KY

General Provider Information

NPI Number	:	1659238913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON DOYLE SLUSHER ATC

Provider Business Mailing Address
First Line	:	322 CHERRYWOOD DR
Second Line	:
City	:	FT MITCHELL
State	:	KY
Zip	:	41011-1804
Country	:	US
Telephone Number	:	859-630-8124
Fax Number	:

Provider Business Practice Location Address
First Line	:	322 CHERRYWOOD DR
Second Line	:
City	:	FT MITCHELL
State	:	KY
Zip	:	41011-1804
Country	:	US
Telephone Number	:	859-630-8124
Fax Number	:

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

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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