Provider Demographics
NPI:1972616316
Name:BRANNEN, JEFFREY ALAN (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:BRANNEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 674721
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-4721
Mailing Address - Country:US
Mailing Address - Phone:515-643-2519
Mailing Address - Fax:515-222-7601
Practice Address - Street 1:1601 NW 114TH ST STE 342
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-7036
Practice Address - Country:US
Practice Address - Phone:515-222-7600
Practice Address - Fax:515-222-7601
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2025-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IADO-03584207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1972616316Medicaid
IA719260113Medicare PIN