Brandon Scott Funk, PA-C Valid NPI

Individual provider · Physician Assistant · Edmond, OK

NPI

1396785390

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

License number

1465 (OK)

Sex

Male

Sole proprietor

No

Enumerated

2006-06-07

Last updated

2022-09-08