Individual
DR. CHARLES O BRANTIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12605 E 16TH AVE, AURORA, CO 80045-2545
(720) 848-0000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
16213
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01162130
—
CO
01
—
COAAA1301
MEDICARE PTAN
CO
01
—
P00039917
RAILROAD MEDICARE
—
Enumeration date
07/11/2005
Last updated
05/28/2013
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