Brandon Medical Group PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO212 Issued in TN

Legal business name

BRANDON MEDICAL GROUP PLLC

Practice address

482 Interstate Dr Ste a
Manchester, TN 37355-3109

Phone

(931) 728-4718

NPI assigned

Aug 15, 2007

Last updated

Jun 5, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Albert R Brandon, D ONPI 1376570424

Title

Physician

Phone

(931) 728-4718

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Albert R Brandon Jr., DO

  • Family Medicine Physician
  • Manchester, TN
  • NPI 1376570424
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338854400000",
    "number": "1346432010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 INTERSTATE DR STE A",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373553109",
            "telephone_number": "931-728-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 INTERSTATE DR STE A",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373553109",
            "telephone_number": "931-728-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDON MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2012-06-05",
        "status": "A",
        "authorized_official_last_name": "BRANDON",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "931-728-4718",
        "authorized_official_credential": "D O"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "DO212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristi Lee Bouldin, DPM
• Eric B Bouldin, D.P.M.
• Macey Elyse Bowman
• Ronald Bradford, D.PH.
• Robin Michael Brady, OD
• Albert R Brandon Jr., DO
• Nicole Lynn Brinkley, FNP
• Ruth Brooks, PTA
• Courtney Johnson Brown, LCSW
• Katherine Rose Brown, LMT, MMP

• Family Medicine Physician in Manchester, TN
• Providers in Manchester, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.