BRANDON MEDICAL, LLC (NPI# 1073511184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073511184 |
| Entity Type | Organization |
| Organization Name | BRANDON MEDICAL, LLC |
| Other Organization Name | BRANDON MEDICAL, LLC |
| Practice Address |
110 North Lee Street Fort Gibson OK 74434 |
| Mailing Address |
Po Box 684 Fort Gibson OK 74434-0684 |
| Practice Telephone | 9184782845 |
| Practice Fax Number | 9184785519 |
| Mailing Telephone | 9184782845 |
| Mailing Fax Number | 9184785519 |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2008-09-30 |
| Authorized Official Name | STEVEN M BRANDON (PRESIDENT) |
| Authorized Official Telephone | 9184782845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100812890A | 05 |
| Other Name | Type Code |
|---|---|
| BRANDON MEDICAL, LLC | Doing Business As Name - Organization |
| Street Address |
110 NORTH LEE STREET |
| City | FORT GIBSON |
| State | OK |
| Zip Code | 74434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326323296 | Janet Hulbert | Occupational Therapist | 1409 Saddlebrooke Dr, Fort Gibson, OK 74434 | 2011-10-11 |
| 1356643936 | Justin Matthew Wedman | Pharmacist | 114 N. Lee St., Fort Gibson, OK 74434 | 2010-12-02 |
| 1396980546 | Walker & Walker P.l.l.c. | Dentist | 106 Lone Oak Cr, Ft. Gibson, OK 74434 | 2008-12-02 |
| 1548305857 | Christopher Back | Family Medicine | 129 N Lee St., Fort Gibson, OK 74434 | 2007-02-21 |
| 1982794442 | Wanda Ann Teague | Speech-Language Pathologist | 500 South Ross Ave., Fort Gibson, OK 74434 | 2006-10-13 |
| 1891898912 | Scotts Pharmacy LLC | Pharmacy | 1201 S Lee St, Fort Gibson, OK 74434 | 2006-09-06 |
| 1831206671 | Charles Robert Mutch | Family Medicine | 104 Lone Oak Circle, Ft. Gibson, OK 74434 | 2006-08-25 |
| 1265761381 | Holly Jean Dawson | Obstetrics & Gynecology | 108 Lone Oak Cir, Fort Gibson, OK 74434 | 2009-12-19 |
| 1790892529 | Donald M Elgin | Family Medicine | 104 Lone Oak Circle, Ft. Gibson, OK 74434 | 2006-08-25 |
| 1942352919 | Frank J Evans | Dentist | 802 S Lee, Fort Gibson, OK 74434-0206 | 2007-01-18 |
| Find all providers in zip 74434 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619515541 | Lamoor Beauty Supply | Prosthetic/Orthotic Supplier | 2214 N Martin Luther King Ave, Oklahoma City, OK 73111-2404 | 2019-12-10 |
| 1790246361 | Capitol Orthopedic Inc | Prosthetic/Orthotic Supplier | 5480 Main St, Del City, OK 73115-5516 | 2019-03-27 |
| 1841776705 | Progressive Orthotic & Prosthetic Services, Inc | Prosthetic/Orthotic Supplier | 10 E 6th St., Grove, OK 74344 | 2018-07-13 |
| 1598258378 | Otto Bock Orthopedic Services LLC | Prosthetic/Orthotic Supplier | 5601 Nw 72nd Street, Suite 257, Oklahoma City, OK 73132-5920 | 2018-06-07 |
| 1508363482 | Progressive Orthotic & Prosthetic Services, Inc | Prosthetic/Orthotic Supplier | 2121 S Columbia Ave Ste Ll8, Tulsa, OK 74114-3512 | 2018-04-09 |
| 1093237711 | Elevate Orthotics and Prosthetics LLC | Prosthetic/Orthotic Supplier | 3317 E Memorial Rd Ste 103, Edmond, OK 73013-7095 | 2017-07-14 |
| 1710413489 | Raymon Turpin | Prosthetic/Orthotic Supplier | 6565 S Yale Ave Ste 901, Tulsa, OK 74136-8310 | 2017-05-02 |
| 1265970040 | Fenner, Inc | Prosthetic/Orthotic Supplier | 2019 W Broadway St, Muskogee, OK 74401-2759 | 2017-02-01 |
| 1336510874 | Tatas for Now | Prosthetic/Orthotic Supplier | 2319 W Gore Blvd, Lawton, OK 73505-6301 | 2015-10-09 |
| 1639577885 | La Fuente Prosthetics | Prosthetic/Orthotic Supplier | 229 N.w. 9th Street, Oklahoma City, OK 73102 | 2014-12-19 |
| Find all providers with the same taxonomy | ||||
| City | FORT GIBSON |
| Zip Code | 74434 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.