Individual
MR. HENRY J BRANER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
16TH STREET BUILDING 13514, YOUTH CHALLANGE ACADEMY, FT STEWART, GA 31315
(912) 242-6542
(912) 767-6445
Mailing address
603 PEAR ORCHARD LN, STATESBORO, GA 30458-6767
(912) 489-3938
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001989
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000781A
—
GA
Enumeration date
08/31/2006
Last updated
03/28/2016
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