Basic Information
| Provider Information | |||||||||
| NPI: | 1821061128 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRANNEY | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5788 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802175788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3032021280 | ||||||||
| FaxNumber: | 3032021281 | ||||||||
| Practice Location | |||||||||
| Address1: | 11600 W 2ND PL | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802281527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7203214161 | ||||||||
| FaxNumber: | 7203214165 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2006 | ||||||||
| LastUpdateDate: | 04/25/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 35038 | CO | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 121104800 | 05 | WY | MEDICAID | 20326023101 | 01 | PACIFICARE SECURE HORIZONS | OTHER | 01350388 | 05 | CO | MEDICAID | PENDING | 05 | NE | MEDICAID | 8472284 | 05 | WA | MEDICAID | 30083061 | 05 | NM | MEDICAID | 951740 | 05 | AZ | MEDICAID | P00368632 | 01 | RR MEDICARE | OTHER | 610854400 | 01 | US DEPARTMENT OF LABOR | OTHER | Z3292 | 05 | UT | MEDICAID |