Healthcare Provider Details

I. General information

NPI: 1164506101
Provider Name (Legal Business Name): SCOTT A BRANDT MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 S BROADWAY SUITE 240
LITTLETON CO
80122-2632
US

IV. Provider business mailing address

7720 S BROADWAY SUITE 240
LITTLETON CO
80122-2632
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-9308
  • Fax:
Mailing address:
  • Phone: 303-788-9308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number36941
License Number StateCO

VIII. Authorized Official

Name: SCOTT BRANDT
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 303-788-9308