Provider Demographics
NPI:1114345204
Name:BRANNON, JAMES HARRISON (CCP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HARRISON
Last Name:BRANNON
Suffix:
Gender:M
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 OFFICE PARK CIR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2559
Mailing Address - Country:US
Mailing Address - Phone:205-414-3999
Mailing Address - Fax:205-414-3991
Practice Address - Street 1:2010 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-6804
Practice Address - Country:US
Practice Address - Phone:205-877-1830
Practice Address - Fax:205-877-1802
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist