Provider Demographics
NPI:1104814045
Name:RHINEHART, BRANDON (DO)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:RHINEHART
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13100 N WESTERN
Mailing Address - Street 2:STE 301
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-1670
Mailing Address - Country:US
Mailing Address - Phone:405-947-6647
Mailing Address - Fax:405-948-6647
Practice Address - Street 1:13100 N WESTERN
Practice Address - Street 2:STE 301
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-1670
Practice Address - Country:US
Practice Address - Phone:405-947-6647
Practice Address - Fax:405-948-6647
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4552207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology