Individual
THOMAS R BRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1100 VIRGINIA AVE, COLUMBIA, MO 65212-0001
(573) 882-2663
(573) 882-1760
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000339
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106684
HEALTLINK
MO
01
—
24958
BLUE CHOICE
MO
01
—
2709006
UNITED HEALTHCARE
MO
05
—
300749421
—
MO
Enumeration date
05/09/2006
Last updated
06/01/2010
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