Healthcare Provider Details

I. General information

NPI: 1447239389
Provider Name (Legal Business Name): WILLIAM JEFFREY BRANNICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 FRANKLIN ST SE SUITE 200
HUNTSVILLE AL
35801-4551
US

IV. Provider business mailing address

2006 FRANKLIN ST SE STE 200
HUNTSVILLE AL
35801-4537
US

V. Phone/Fax

Practice location:
  • Phone: 256-539-0457
  • Fax: 256-539-5827
Mailing address:
  • Phone: 256-539-0457
  • Fax: 256-539-5827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036177053
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number34928
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD34142
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME124304
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: