Healthcare Provider Details

I. General information

NPI: 1205163003
Provider Name (Legal Business Name): SCOTT A. BRANDT MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2009
Last Update Date: 11/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 E ORCHARD RD SUITE 350
GREENWOOD VILLAGE CO
80111-2583
US

IV. Provider business mailing address

7447 E BERRY AVE SUITE 150
GREENWOOD VILLAGE CO
80111-2146
US

V. Phone/Fax

Practice location:
  • Phone: 303-689-2300
  • Fax:
Mailing address:
  • Phone: 303-689-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number36941
License Number StateCO

VIII. Authorized Official

Name: SCOTT BRANDT
Title or Position: PRESIDENT
Credential: MD
Phone: 303-689-2300