Provider Demographics
NPI:1437177045
Name:BRANSON, JAMES WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAM
Last Name:BRANSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4895 EAST MAIN ST.
Mailing Address - Street 2:PO BOX 879
Mailing Address - City:ERIN
Mailing Address - State:TN
Mailing Address - Zip Code:37061-0879
Mailing Address - Country:US
Mailing Address - Phone:931-289-5024
Mailing Address - Fax:931-289-5025
Practice Address - Street 1:4895 EAST MAIN ST.
Practice Address - Street 2:
Practice Address - City:ERIN
Practice Address - State:TN
Practice Address - Zip Code:37061
Practice Address - Country:US
Practice Address - Phone:931-289-5024
Practice Address - Fax:931-289-5025
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD26393208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3089727Medicare ID - Type Unspecified
TNG05909Medicare UPIN