Individual
DR. BRANDON RICHARD LEWIS DEATHERAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1625 N CAMPBELL AVE, TUCSON, AZ 85719-4330
(520) 694-0111
Mailing address
1501 N CAMPBELL AVE RM 6207, TUCSON, AZ 85724-0001
(520) 626-1376
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
R4027
AZ
Other
Enumeration date
04/26/2023
Last updated
04/26/2023
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