Provider Demographics
NPI:1447781158
Name:GETTYS, BRANDY (MD)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:GETTYS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5075 PARKWAY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-9555
Mailing Address - Country:US
Mailing Address - Phone:513-584-6898
Mailing Address - Fax:513-584-6897
Practice Address - Street 1:5075 PARKWAY DR STE 101
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-9555
Practice Address - Country:US
Practice Address - Phone:513-584-6898
Practice Address - Fax:513-584-6897
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.138984207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0407238Medicaid