Healthcare Provider Details

I. General information

NPI: 1598804825
Provider Name (Legal Business Name): JAMES T BRAWNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 10/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 S PAYNE STEWART DR STE 201
BRANSON MO
65616-2732
US

IV. Provider business mailing address

186 S PAYNE STEWART DR STE 201
BRANSON MO
65616-2732
US

V. Phone/Fax

Practice location:
  • Phone: 417-335-3636
  • Fax: 417-335-3626
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number23984
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number2009001424
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: