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Individual
JAMES J BRANTLEY
Active
Individual
JAMES J BRANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
152
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11443421
CAQH PROVIDER NUMBER
AR
01
—
152
STATE PODIATRY LICENSE
AR
Enumeration date
06/15/2005
Last updated
05/05/2016
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