Brant, Thomas R

Brant, Thomas R is an individual health care provider with primary practice located at 1100 Virginia Ave , Columbia MO 65212-0001. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Brant, Thomas R can be contacted via phone (573) 882-2663.

Contact Information

Primary practice address
1100 Virginia Ave Columbia MO 65212-0001
Phone: (573) 882-2663
Fax: (573) 882-1760
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 000339 Missouri

Profile Details

NPI number 1619926490
LBN Legal business name Brant, Thomas R
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2006
Last updated Jun 1st, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619926490 NPPES
Missouri Other 24958 BLUE CHOICE
Missouri Other 2709006 BLUE CHOICE
Missouri Other 24958 BLUE CHOICE
Missouri Other 106684 BLUE CHOICE
Missouri MEDICAID 300749421 BLUE CHOICE

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