Provider Demographics
NPI:1578863684
Name:SCOTT A. BRANDT, MD, PC
Entity Type:Organization
Organization Name:SCOTT A. BRANDT, MD, PC
Other - Org Name:DENVER PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTARTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-689-2300
Mailing Address - Street 1:7447 E. BERRY AVE.
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111
Mailing Address - Country:US
Mailing Address - Phone:303-689-2300
Mailing Address - Fax:
Practice Address - Street 1:8227 S. HOLLY ST.
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122
Practice Address - Country:US
Practice Address - Phone:303-689-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36941174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF68027Medicare UPIN
COC806955Medicare PIN