Brandon Medical, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

BRANDON MEDICAL, LLC

Doing business as

Brandon Medical, LLC

Practice address

110 North Lee Street
Fort Gibson, OK 74434

Phone

(918) 478-2845

Fax

(918) 478-5519

NPI assigned

Jul 12, 2005

Last updated

Sep 30, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Steven M Brandon

Title

President

Phone

(918) 478-2845

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BRANDON MEDICAL, LLC Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1073511184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 684",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "744340684",
            "telephone_number": "918-478-2845",
            "fax_number": "918-478-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 NORTH LEE STREET",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "74434",
            "telephone_number": "918-478-2845",
            "fax_number": "918-478-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDON MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "BRANDON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-478-2845"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100812890A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRANDON MEDICAL, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany Arnold
• Ruby Austin, M.S. CCC-SLP
• Casey Bear
• Tracy Lynn Berry-Igert, MSN APRN FNP-C
• Donna Bradford, COTA
• Maricsa Brown
• Kelsey Buford, OD
• Marjorie Lisa Butikofer, OTR
• James Bywater
• Erin Lee Carrell, BSW

• Prosthetic/Orthotic Supplier in Fort Gibson, OK
• Providers in Fort Gibson, OK by specialty
• Prosthetic/Orthotic Supplier in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.