Brant Michael Southam, O.D.

NPI #1831427160 in Reno, Nevada

Provider Information

NPI Number: 1831427160
Entity Type: Individual
Name: Brant Michael Southam, O.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Nov 24, 2009
Last Updated: Aug 30, 2018

Practice Location

Address: 3201 LAKESIDE DR
City: Reno
State: Nevada
ZIP Code: 89509
Phone: (775) 825-0559

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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