| Doctor Name: | DR. BRENT JAMES THIELGES |
| NPI Number: | 1043507973 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | SC006314 |
| Business Practice Address: | 303 Bradley Blvd Suite 200 Richland, WA - 993524497 |
| Business Phone Number: | 5092926270 |
| Business Fax Number: | 5095781118 |
| Mailing Address: | 303 Bradley Blvd, Suite 200 RICHLAND |
| State: | WA |
| Postal Code: | 993524497 |
| Phone Number: | 5092926270 |
| Fax Number: | |
| NPI Enumeration Date: | 06/29/2011 |
| NPI Last Update Date: | 09/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | SC006314 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |