Organization · Type 2 NPI

Isd Brandon LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Brandon, MS

NPI number 1790723831 Active

Practice location

101 Christian Dr
Brandon, MS 39042-2678

Call (601) 824-9764 Map

Fax (601) 824-9761

Mailing address

5200 Virginia Way, L&c Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

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NPI record

NPI: 1790723831
Entity type: Organization (Type 2)
Issued: Jun 2, 2006
Last updated: Dec 1, 2025
Status: Active

Other names

<unavail>
Brandon Renal Center · doing business as
Brandon Renal Center · doing business as

Authorized official

Samuel T Wey
VP Licensure & Certification
(615) 341-6641

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1790723831

Isd Brandon LLC's National Provider Identifier is 1790723831, issued on Jun 2, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Brandon, MS. The record was last updated on Dec 1, 2025.