Basic Information
| Provider Information | |||||||||
| NPI: | 1316480718 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BRAMLETT ORTHOPAEDIC LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 MONTGOMERY HWY | ||||||||
| Address2: | STE 200 | ||||||||
| City: | VESTAVIA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352161842 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 200 MONTGOMERY HWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | VESTAVIA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352161896 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2052593991 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2016 | ||||||||
| LastUpdateDate: | 03/21/2017 | ||||||||
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| AuthorizedOfficialLastName: | BRAMLETT | ||||||||
| AuthorizedOfficialFirstName: | KENNETH | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 2052593991 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 10293 | AL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.