| Doctor Name: | MR. BRANDON D FOUTCH |
| NPI Number: | 1184957805 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP, FNP-BC |
| License Number: | ARNP9258198 |
| Business Practice Address: | 4684 Highway 90 Marianna, FL - 324463503 |
| Business Phone Number: | 8663892727 |
| Business Fax Number: | 8775022767 |
| Mailing Address: | 2039 N Meridian Rd Apt 280, TALLAHASSEE |
| State: | FL |
| Postal Code: | 323035068 |
| Phone Number: | 8505083098 |
| Fax Number: | 8775022767 |
| NPI Enumeration Date: | 09/14/2009 |
| NPI Last Update Date: | 03/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ARNP9258198 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |