Individual
DR. BRANDT THOMAS LYDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-8917
(314) 454-7524
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2019015692
MO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2019015692
MO
207RP1001X
Pulmonary Disease Physician
Primary
2019015692
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200060859
—
MO
Enumeration date
07/19/2016
Last updated
09/08/2025
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