Provider Demographics
NPI:1659736775
Name:BRETT, AUSTIN M (PA)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:M
Last Name:BRETT
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 7549
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0549
Mailing Address - Country:US
Mailing Address - Phone:757-686-3525
Mailing Address - Fax:757-686-0541
Practice Address - Street 1:4092 FOXWOOD DR
Practice Address - Street 2:STE 101
Practice Address - City:VA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5225
Practice Address - Country:US
Practice Address - Phone:757-686-3525
Practice Address - Fax:757-686-0541
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical