Provider Demographics
NPI:1316955040
Name:ALLEN, BRANDON D (MD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:D
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 ALBION ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-2918
Mailing Address - Country:US
Mailing Address - Phone:615-341-4578
Mailing Address - Fax:
Practice Address - Street 1:109 DEL RIO PIKE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-2577
Practice Address - Country:US
Practice Address - Phone:615-435-3854
Practice Address - Fax:833-464-2713
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN49733208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
700H262220OtherBLUE CROSS-BLUE CROSS
MI489527610Medicaid
BA080305OtherCHAMPUS-CHAMPUS
BA080305OtherCOMMERCIAL-COMMERCIAL NUMBER
BA080305OtherCOMMERCIAL-COMMERCIAL NUMBER
MI489527610Medicaid