| Sharon K. Brandon, Llc | |
|
722 Maple Ridge Trl Poplar Bluff MO 63901-2216 | |
| (573) 429-0133 | |
| (573) 686-7525 |
| Full Name | Sharon K. Brandon, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 722 Maple Ridge Trl, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Sharon K. Brandon (MEMBER) |
| Authorized Official Contact | 5734290133 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sharon K. Brandon, Llc 722 Maple Ridge Trl Poplar Bluff MO 63901-2216 Ph: (573) 429-0133 | Sharon K. Brandon, Llc 722 Maple Ridge Trl Poplar Bluff MO 63901-2216 Ph: (573) 429-0133 |
| NPI Number | 1912121807 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912121807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | R9547 (Missouri) | Primary |
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