Individual
BRANDON SCOTT FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2017 W I 35 FRONTAGE RD STE 250, EDMOND, OK 73013-8561
(405) 757-3340
(405) 757-3520
Mailing address
2017 W I 35 FRONTAGE RD STE 250, EDMOND, OK 73013-8561
(405) 757-3340
(405) 757-3520
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1465
OK
363A00000X
Physician Assistant
PA17988
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200201770A
—
OK
Enumeration date
06/07/2006
Last updated
09/08/2022
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