Individual
DR. KENT PHILIP BRANTLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10122 E 10TH ST STE 100, INDIANAPOLIS, IN 46229-2697
(317) 355-5717
Mailing address
1617 HEMPHILL ST, FORT WORTH, TX 76104-4709
(817) 702-2396
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01096271A
IN
207Q00000X
Family Medicine Physician
P0816
TX
Other
Enumeration date
09/12/2009
Last updated
08/05/2025
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