Individual
DOUGLAS W BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3269 STOCKTON HILL RD, KINGMAN, AZ 86409-3619
(928) 757-0620
Mailing address
3269 STOCKTON HILL RD, KINGMAN, AZ 86409-3619
(928) 757-0620
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
49933
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073195000
—
MN
Enumeration date
07/03/2007
Last updated
08/31/2011
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