Provider Demographics
NPI:1396622387
Name:BEN BRANNICK LLC
Entity type:Organization
Organization Name:BEN BRANNICK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-993-6601
Mailing Address - Street 1:491 W POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-2537
Mailing Address - Country:US
Mailing Address - Phone:901-286-4162
Mailing Address - Fax:901-286-4199
Practice Address - Street 1:491 W POPLAR AVE
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-2537
Practice Address - Country:US
Practice Address - Phone:901-286-4162
Practice Address - Fax:901-286-4199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty