Individual
JAMES KEVIN BRANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1500 ROSS CLARK CIR, DOTHAN, AL 36301-4754
(334) 793-2663
(334) 836-2248
Mailing address
PO BOX 729, DOTHAN, AL 36302-0729
(334) 793-2663
(334) 836-2248
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-582
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003184448 A & B
—
GA
05
—
192973
—
AL
05
—
193179
—
AL
01
—
511-84985
BCBS OF ALABAMA - RCC
AL
01
—
511-84987
BCBS OF ALABAMA - HW
AL
Enumeration date
04/23/2008
Last updated
02/17/2017
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