Physician Compare National (NPI:1588656094)

HEALTHCARE PROVIDER: DOUGLAS BRANT JR. D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1588656094
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4082649660
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20051227000185
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BRANT
	Individual professional last name
Provider First Name	DOUGLAS
	Individual professional first name
Provider Middle Name	W
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DO
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	CAH ACQUISITION COMPANY 4, INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9830242031
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2340 E MAIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 3
	Group Practice or individual's line 2 address
City	CUSHING
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	740232905
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9182256904
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	371331
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	DRUMRIGHT REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M