Provider Demographics
NPI:1699904847
Name:BRIAN K BELNAP MD PLLC
Entity type:Organization
Organization Name:BRIAN K BELNAP MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BELNAP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-963-0582
Mailing Address - Street 1:2754 COMPASS DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8714
Mailing Address - Country:US
Mailing Address - Phone:970-858-9871
Mailing Address - Fax:
Practice Address - Street 1:228 N CHERRY ST
Practice Address - Street 2:
Practice Address - City:FRUITA
Practice Address - State:CO
Practice Address - Zip Code:81521-2101
Practice Address - Country:US
Practice Address - Phone:970-858-9871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47796207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty