Broadbent, Bryan Kent

Broadbent, Bryan Kent is an individual health care provider with primary practice located at 2300 E 30Th St Bldg D-101 , Farmington NM 87401-8991. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as his primary health care specialty. Broadbent, Bryan Kent can be contacted via phone (505) 327-1400.

Contact Information

Primary practice address
2300 E 30Th St Bldg D-101 Farmington NM 87401-8991
Phone: (505) 327-1400
Fax: (505) 564-3202
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X POD417 New Mexico
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X DP 00375 Oregon
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X POD.0000831 Colorado

Profile Details

NPI number 1215011218
LBN Legal business name Broadbent, Bryan Kent
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2006
Last updated Oct 1st, 2019 - about 6 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 1215011218 NPPES
New Mexico MEDICAID 10432353

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