Individual
DR. JOHN CARLYN BRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1057 MEDICAL PARK DR, OSAGE BEACH, MO 65065-3000
(573) 302-3100
(573) 348-8279
Mailing address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(417) 829-4620
(573) 348-8309
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2011012163
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144451774
—
MO
01
—
2011012163
MO STATE LICENSE
MO
Enumeration date
07/30/2009
Last updated
12/15/2017
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