Basic Information
| Provider Information | |||||||||
| NPI: | 1447781158 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GETTYS | ||||||||
| FirstName: | BRANDY | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5075 PARKWAY DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | MASON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450409555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135846898 | ||||||||
| FaxNumber: | 5135846897 | ||||||||
| Practice Location | |||||||||
| Address1: | 5075 PARKWAY DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | MASON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450409555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135846898 | ||||||||
| FaxNumber: | 5135846897 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2017 | ||||||||
| LastUpdateDate: | 08/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35.138984 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0407238 | 05 | OH | MEDICAID |