Provider Demographics
NPI:1164506101
Name:SCOTT A BRANDT MD PC
Entity Type:Organization
Organization Name:SCOTT A BRANDT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-788-9308
Mailing Address - Street 1:7720 S BROADWAY
Mailing Address - Street 2:SUITE 240
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2632
Mailing Address - Country:US
Mailing Address - Phone:303-788-9308
Mailing Address - Fax:
Practice Address - Street 1:7720 S BROADWAY
Practice Address - Street 2:SUITE 240
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2632
Practice Address - Country:US
Practice Address - Phone:303-788-9308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO369412081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty