Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 35076811 | OH |
Y | 207W00000X | Ophthalmologist | ME102185 | FL |
N | 2086S0122X | Plastic and Reconstructive Surgery | ME102185 | FL |
NPI | 1235126186 |
---|---|
Provider Name | Dr. Paul Anderson Brannan |
First Address | Sarasota, FL 34233-3228 |
Second Address | Sarasota, FL 34233-3228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 07/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000278292 | BCBS FACET NUMBER (01) | OH |
10000440 | (05) | IN |
2307104 | (05) | OH |
64038763 | (05) | KY |
H80617 | (02) | OH |