Provider Demographics
NPI:1275823668
Name:BRENNARD, MEGAN GLADDEN (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:GLADDEN
Last Name:BRENNARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 BECKHAM DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-1481
Mailing Address - Country:US
Mailing Address - Phone:256-504-4023
Mailing Address - Fax:
Practice Address - Street 1:1508 BECKHAM DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-1481
Practice Address - Country:US
Practice Address - Phone:256-504-4023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN562532080P0204X
ALMD.32073208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-49271OtherBCBS
AL160750Medicaid
AL511-49272OtherBCBS
AL160797Medicaid