Basic Information
Provider Information
NPI: 1346598521
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SERRATOS
FirstName: BRITTANY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 520 S 7TH ST
Address2:  
City: VINCENNES
State: IN
PostalCode: 475911038
CountryCode: US
TelephoneNumber: 8128825220
FaxNumber: 8128853175
Practice Location
Address1: 520 S 7TH ST
Address2:  
City: VINCENNES
State: IN
PostalCode: 475911038
CountryCode: US
TelephoneNumber: 8128825220
FaxNumber: 8128853175
Other Information
ProviderEnumerationDate: 08/20/2012
LastUpdateDate: 10/26/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X01077680AINY Allopathic & Osteopathic PhysiciansAnesthesiology 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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