Basic Information
| Provider Information | |||||||||
| NPI: | 1093780801 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRANNON | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8101 W 135TH ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662231111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9134913999 | ||||||||
| FaxNumber: | 9134919309 | ||||||||
| Practice Location | |||||||||
| Address1: | 8101 W 135TH ST STE 200 | ||||||||
| Address2: | THE HEADACHE & PAIN CENTER, PA | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662231111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9134913999 | ||||||||
| FaxNumber: | 9134919309 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2006 | ||||||||
| LastUpdateDate: | 06/02/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 0433093 | KS | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 1093780801 | 05 | MO | MEDICAID | 200308870B | 05 | KS | MEDICAID |