Provider Demographics
NPI:1578131306
Name:BRINSON, SAMUEL P (DO)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:P
Last Name:BRINSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1366 N GARDNER ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47170-7793
Mailing Address - Country:US
Mailing Address - Phone:812-752-7444
Mailing Address - Fax:812-752-6855
Practice Address - Street 1:1366 N GARDNER ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-7793
Practice Address - Country:US
Practice Address - Phone:812-752-7444
Practice Address - Fax:812-752-6855
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2024-06-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN02006855A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine