Individual
DR. JIM N BRANTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1303 SUNSET DR, SUITE 5, JOHNSON CITY, TN 37604-7905
(423) 328-9000
(423) 328-9007
Mailing address
1303 SUNSET DR STE 5, JOHNSON CITY, TN 37604-7905
(423) 328-9000
(423) 328-9007
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD25117
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178630
BLUECROSS BLUESHIELD
TN
05
—
3081165
—
TN
Enumeration date
10/19/2005
Last updated
11/13/2019
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