Doctor Name: | GREGORY BRANSTETTER |
NPI Number: | 1083769681 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CST,CFA,KCSA |
License Number: | 82418 |
Business Practice Address: | 106 Columns Plaza Dr Glasgow, KY - 421418068 |
Business Phone Number: | 2706519390 |
Business Fax Number: | 2706518698 |
Mailing Address: | 106 Columns Plaza Dr, GLASGOW |
State: | KY |
Postal Code: | 421418068 |
Phone Number: | 2706519390 |
Fax Number: | 2706518698 |
NPI Enumeration Date: | 01/24/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 82418 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |