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General NPI Number Information
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NPI Number | 1184887937
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Entity Type | Individual
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Provider Name | RYAN K BRANNON M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 245 N 15TH ST # MS 495 ROOM 16121, 16FH FL - NCB
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1101
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Country | US
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Telephone | 215-762-8220
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Fax | 215-762-1470
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Provider Business Mailing Address
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Address Line | 1601 CHERRY ST SUITE 11511
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1320
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Country | US
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Telephone | 215-255-7822
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Fax | 215-255-7825
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD442294
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License Number State | PA
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