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General NPI Number Information
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NPI Number | 1346244985
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Entity Type | Individual
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Provider Name | JAMES PALMER BRANCH D.P.M
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Gender | Male
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 06/27/2011
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Provider Practice Location Address
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Address Line | 4705 LAWRENCEVILLE HWY NW SUITE C
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City | LILBURN
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State | GA
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Zip | 30047-3667
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Country | US
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Telephone | 770-921-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 4705 LAWRENCEVILLE HWY NW SUITE C
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City | LILBURN
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State | GA
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Zip | 30047-3667
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Country | US
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Telephone | 770-921-8800
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Fax |
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | POD000918
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License Number State | GA
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