Provider Demographics
NPI:1225355407
Name:OLAND, BRENT GERALD (PA)
Entity Type:Individual
Prefix:MR
First Name:BRENT
Middle Name:GERALD
Last Name:OLAND
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:899 S RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-8276
Mailing Address - Country:US
Mailing Address - Phone:931-206-9247
Mailing Address - Fax:
Practice Address - Street 1:1850 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6085
Practice Address - Country:US
Practice Address - Phone:931-245-7092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant