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NPI Code Detail

MEDICARE: DENNIS P. BRANT

MEDICARE: DENNIS P. BRANT
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
1207P00000XEmergency Medicine PhysicianPA.0003152CO
2363A00000XPhysician Assistant001120IA
3363A00000XPhysician AssistantPA.0003152CO

General Provider Information

NPI Number : 1487659181
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS P. BRANT
Provider Business Mailing Address
First Line : PO BOX 912215
Second Line :
City : DENVER
State : CO
Zip : 80291-2215
Country : US
Telephone Number : 303-306-7783
Fax Number : 303-306-7753
Provider Business Practice Location Address
First Line : 1024 S LEMAY AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-3929
Country : US
Telephone Number : 970-495-7000
Fax Number : 970-495-7611
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 09/13/2018

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