Provider Demographics
NPI:1437148673
Name:BRANAM, JAMES WILLIE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIE
Last Name:BRANAM
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1775
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31202-1775
Mailing Address - Country:US
Mailing Address - Phone:478-405-9945
Mailing Address - Fax:478-405-9951
Practice Address - Street 1:4112 ARKWRIGHT RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1707
Practice Address - Country:US
Practice Address - Phone:478-405-9945
Practice Address - Fax:478-405-9951
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0204092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52244194OtherBLUE CROSS BLUE SHIELD
GA52244194OtherBLUE CROSS BLUE SHIELD