Healthcare Provider Details

I. General information

NPI: 1093150690
Provider Name (Legal Business Name): BRANDEN LEE QUINLAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 MEDICAL CIR SUITE 1
MOREHEAD KY
40351-1194
US

IV. Provider business mailing address

234 MEDICAL CIR STE 1
MOREHEAD KY
40351-1194
US

V. Phone/Fax

Practice location:
  • Phone: 606-784-6641
  • Fax: 606-780-2379
Mailing address:
  • Phone: 606-784-6641
  • Fax: 606-780-2379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number03931
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number03931
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR3304
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: