Provider Demographics
NPI:1841221108
Name:BRANDON, JIMMY WAYNE (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:JIMMY
Middle Name:WAYNE
Last Name:BRANDON
Suffix:
Gender:M
Credentials:DO, MPH
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Mailing Address - Street 1:4555 GIDDINGS ROAD / MAIL CODE 483-900-006
Mailing Address - Street 2:GENERAL MOTORS HEALTH SERVICES / LAKE ORION ASSEMBLY
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48361-8037
Mailing Address - Country:US
Mailing Address - Phone:248-377-5482
Mailing Address - Fax:
Practice Address - Street 1:G-3100 VAN SLYKE ROAD
Practice Address - Street 2:GENERAL MOTORS HEALTH SERVICES / FLINT ASSEMBLY
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48551
Practice Address - Country:US
Practice Address - Phone:810-236-6411
Practice Address - Fax:810-234-6411
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2022-10-08
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Provider Licenses
StateLicense IDTaxonomies
MI5101011123207P00000X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE93975Medicare UPIN