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Individual

BRANNON RUSSELL CHURCHWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
405 W GRAND AVE, DAYTON, OH 45405-4720
(937) 723-3248
Mailing address
2340 FOXHILL DR APT 1C, MIAMISBURG, OH 45342-5636
(404) 408-6518

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2024016823
MO
207L00000X
Anesthesiology Physician
58.003157
OH

Other

Enumeration date
10/20/2009
Last updated
11/05/2024
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