Individual
DR. DAVID BRUCE BRANTLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 N RIVER ST, CLAXTON, GA 30417-1659
(912) 882-4870
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
028506
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00327269L
—
GA
Enumeration date
05/19/2006
Last updated
07/08/2007
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