Organization
BRANDON MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT R BRANDON D O (PHYSICIAN)
(931) 728-4718
Entity
Organization
Contact information
Practice address
482 INTERSTATE DR STE A, MANCHESTER, TN 37355-3109
(931) 728-4718
Mailing address
482 INTERSTATE DR STE A, MANCHESTER, TN 37355-3109
(931) 728-4718
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO212
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3730155
—
TN
01
—
4107876
BCBST
TN
Enumeration date
08/15/2007
Last updated
06/05/2012
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