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NPI Code Detail

MEDICARE: JASON EDWARD BRANDON MS

MEDICARE:   JASON EDWARD BRANDON  MS
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
1101YM0800XMental Health Counselor12787OK
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1376020677
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON EDWARD BRANDON MS
Provider Business Mailing Address
First Line : 24 N EIGHT TRIBES TRL
Second Line :
City : MIAMI
State : OK
Zip : 74354-1011
Country : US
Telephone Number : 918-387-8720
Fax Number :
Provider Business Practice Location Address
First Line : 24 N EIGHT TRIBES TRL
Second Line :
City : MIAMI
State : OK
Zip : 74354-1011
Country : US
Telephone Number : 918-325-3129
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2018
Last Update Date : 06/05/2025

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Directions to “ JASON EDWARD BRANDON MS” Practice Location

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