Provider Demographics
NPI:1942287669
Name:NOONE, BRENDAN MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:MICHAEL
Last Name:NOONE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:307 BOATNER RD STE 114
Mailing Address - Street 2:
Mailing Address - City:EGLIN AFB
Mailing Address - State:FL
Mailing Address - Zip Code:32542-1302
Mailing Address - Country:US
Mailing Address - Phone:850-883-9507
Mailing Address - Fax:
Practice Address - Street 1:18 MEDICAL GROUP / KADENA AIR BASE, JAPAN
Practice Address - Street 2:FLIGHT MEDICINE CLINIC
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96368
Practice Address - Country:US
Practice Address - Phone:01181611-730-4305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3685207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine