Healthcare Provider Details

I. General information

NPI: 1245659309
Provider Name (Legal Business Name): BRANDON TODD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7550 WOLF RIVER BLVD STE 102
GERMANTOWN TN
38138-1779
US

IV. Provider business mailing address

7550 WOLF RIVER BLVD STE 102
GERMANTOWN TN
38138-1779
US

V. Phone/Fax

Practice location:
  • Phone: 901-767-5000
  • Fax: 901-767-6000
Mailing address:
  • Phone: 901-767-5000
  • Fax: 901-767-6000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number55801
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: