MEDICARE: SCOTT A. BRANDT, MD, PC

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	261QP3300X	Pain Clinic/Center	36941	CO

General Provider Information

NPI Number	:	1649595802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT A. BRANDT, MD, PC

Provider Business Mailing Address
First Line	:	7447 E BERRY AVE STE 150
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-2142
Country	:	US
Telephone Number	:	303-689-2300
Fax Number	:

Provider Business Practice Location Address
First Line	:	7075 CAMPUS DR STE 102
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-6524
Country	:	US
Telephone Number	:	303-689-2300
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CHRIS J DOOLEY
Credential	:
Telephone Number	:	303-689-2380

Provider Enumeration Date	:	03/31/2010
Last Update Date	:	03/31/2010

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