MEDICARE: MR. JEREMY J BRANDT PA-C

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	207Q00000X	Family Medicine Physician	1500619	KS
2	363A00000X	Physician Assistant	1500619	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376523878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEREMY J BRANDT PA-C

Provider Business Mailing Address
First Line	:	2337 HIGHWAY 9
Second Line	:
City	:	FRANKFORT
State	:	KS
Zip	:	66427
Country	:	US
Telephone Number	:	785-292-4451
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 E 2ND ST
Second Line	:
City	:	FRANKFORT
State	:	KS
Zip	:	66427-1403
Country	:	US
Telephone Number	:	785-292-4451
Fax Number	:	785-292-4286

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	04/12/2024

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