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General NPI Number Information
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NPI Number | 1992884068
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Entity Type | Organization
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Legal Business Name | BRANNON OBSTETRICS & GYNECOLOGY, P.A.
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 06/25/2012
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Provider Practice Location Address
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Address Line | 530 NEW WAVERLY PL SUITE 301
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City | CARY
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State | NC
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Zip | 27511-7414
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Country | US
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Telephone | 919-851-3480
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Fax | 919-851-3381
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Provider Business Mailing Address
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Address Line | PO BOX 843332
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City | BOSTON
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State | MA
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Zip | 02284-3332
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Country | US
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Telephone | 919-851-3480
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Fax | 919-851-3381
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY JOSEPH BRANNON
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Credential | M.D.
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Telephone | 919-851-3480
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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 | 76155
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License Number State | NC
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