Provider Demographics
NPI:1265610380
Name:MAY, BRENDA MAY (DO)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:MAY
Last Name:MAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:MAY
Other - Last Name:MEREDITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1605 S LOCUST AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-4053
Mailing Address - Country:US
Mailing Address - Phone:931-766-4560
Mailing Address - Fax:931-762-8206
Practice Address - Street 1:1605 S LOCUST AVE STE 200
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-4053
Practice Address - Country:US
Practice Address - Phone:931-766-4560
Practice Address - Fax:931-762-8206
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015516207V00000X
VA0102203772207VX0201X
PAOT012063390200000X
TN3336207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1599056OtherGATEWAY
PA417116OtherUPMC
PA1025826040001Medicaid
PA2618261OtherHIGHMARK BLUE SHIELD-WMG
PA30100070OtherAMERIHEALTH MERCY-WMG
GA082690OtherGEORGIA MEDICAL LICENSE
MD974288OtherCAREFIRST MD
PA1599056OtherGATEWAY