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General NPI Number Information
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NPI Number | 1780640243
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Entity Type | Individual
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Provider Name | THOMAS BRAND D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 03/14/2015
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Provider Practice Location Address
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Address Line | 17265 MT DR # 4520
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City | BROOKINGS
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State | OR
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Zip | 97415-9296
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Country | US
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Telephone | 514-690-7314
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Fax | 541-469-0731
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Provider Business Mailing Address
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Address Line | PO BOX 4520
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City | BROOKINGS
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State | OR
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Zip | 97415-0075
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Country | US
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Telephone | 514-690-7314
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Fax | 541-469-0731
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | DO20224
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License Number State | OR
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