Provider Demographics
NPI:1851153746
Name:BRANT MEDICAL OF DRUMRIGHT, LLC
Entity Type:Organization
Organization Name:BRANT MEDICAL OF DRUMRIGHT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:918-509-0454
Mailing Address - Street 1:PO BOX 146
Mailing Address - Street 2:
Mailing Address - City:DRUMRIGHT
Mailing Address - State:OK
Mailing Address - Zip Code:74030-0146
Mailing Address - Country:US
Mailing Address - Phone:918-509-0454
Mailing Address - Fax:
Practice Address - Street 1:721 W OLIVE ST
Practice Address - Street 2:
Practice Address - City:STROUD
Practice Address - State:OK
Practice Address - Zip Code:74079-4500
Practice Address - Country:US
Practice Address - Phone:918-968-2075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty