=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457844862
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANTHONY ROBERT BRITTON DO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/11/2018
-----------------------------------------------------
Last Update Date | 12/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 26908 INDEPENDENCE WAY
-----------------------------------------------------
City | EVANS MILLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13637-3300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-629-4525
-----------------------------------------------------
Fax | 315-629-5751
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | ATTN: FINANCIAL CREDENTIALING 830 WASHINGTON ST
-----------------------------------------------------
City | WATERTOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13601-4034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-786-7501
-----------------------------------------------------
Fax | 315-779-5306
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 2020010487
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 314078
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------