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NPI Code Detail

MEDICARE: DR. JOHN BRANNON ALBERTY MD

MEDICARE:  DR. JOHN BRANNON ALBERTY  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician201755LA
22080P0206XPediatric Gastroenterology Physician201755LA
32080P0206XPediatric Gastroenterology PhysicianE-15860AR

Other Identifiers

General Provider Information

NPI Number : 1538195128
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN BRANNON ALBERTY MD
Provider Business Mailing Address
First Line : PO BOX 251418
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72225-1418
Country : US
Telephone Number : 501-364-1100
Fax Number : 501-364-4082
Provider Business Practice Location Address
First Line : 2601 GENE GEORGE BLVD
Second Line :
City : SPRINGDALE
State : AR
Zip : 72762-0845
Country : US
Telephone Number : 479-334-3485
Fax Number : 479-725-6582
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2006
Last Update Date : 10/28/2022

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Directions to “ DR. JOHN BRANNON ALBERTY MD” Practice Location

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