MEDICARE: JAMIE BRANT MD PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1316019847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMIE BRANT MD PLLC

Provider Business Mailing Address
First Line	:	PO BOX 176
Second Line	:
City	:	AVON
State	:	CO
Zip	:	81620-0176
Country	:	US
Telephone Number	:	970-479-8500
Fax Number	:	970-569-7735

Provider Business Practice Location Address
First Line	:	320 BEARD CREEK RD
Second Line	:
City	:	EDWARDS
State	:	CO
Zip	:	81632
Country	:	US
Telephone Number	:	970-479-8500
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	JAMIE LYNN BRANT
Credential	:	MD
Telephone Number	:	970-479-8500

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	11/13/2007

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