Provider Demographics
NPI:1912339888
Name:FORBES, BRANDON EMERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:EMERSON
Last Name:FORBES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7497 BURTON DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-9030
Mailing Address - Country:US
Mailing Address - Phone:419-799-1413
Mailing Address - Fax:
Practice Address - Street 1:630 EATON AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-2767
Practice Address - Country:US
Practice Address - Phone:413-799-1413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.126649171000000X, 207P00000X
OH57.023307208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No171000000XOther Service ProvidersMilitary Health Care Provider
No208600000XAllopathic & Osteopathic PhysiciansSurgery