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NPI Code Detail

MEDICARE: DAVID QUENTEN BRANNON II PHARM.D.

MEDICARE: DAVID QUENTEN BRANNON II PHARM.D.
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
11835P2201XAmbulatory Care Pharmacist44305TN

General Provider Information

NPI Number : 1548873060
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID QUENTEN BRANNON II PHARM.D.
Provider Business Mailing Address
First Line : 122 GAYOSO AVE APT 509
Second Line :
City : MEMPHIS
State : TN
Zip : 38103-2968
Country : US
Telephone Number : 901-288-4831
Fax Number :
Provider Business Practice Location Address
First Line : 2471 JACKSON AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38108-3318
Country : US
Telephone Number : 901-454-1615
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2020
Last Update Date : 08/25/2020

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