Individual
BRANDON GREGORY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1400 E BOULDER ST, SUITE 700, COLORADO SPRINGS, CO 80909-5533
(719) 635-7172
(719) 444-3771
Mailing address
2222N NEVADA AVE 4007, COLORADO SPRINGS, CO 80907-6863
(719) 776-8500
(719) 634-1448
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-2496
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
96130857
—
CO
Enumeration date
07/16/2007
Last updated
09/14/2015
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