Individual
JULIAN C BRANTLEY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
303 GREEN ST E, WILSON, NC 27893-4105
(252) 243-9800
(252) 243-9888
Mailing address
303 GREEN ST E, WILSON, NC 27893-4105
(252) 293-0013
(252) 243-2576
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
21455
NC
208D00000X
General Practice Physician
Primary
21455
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160030995
MEDICARE RAILROAD
NC
01
—
17984
BLUE CROSS BLUE SHIELD
NC
05
—
8917984
—
NC
Enumeration date
09/21/2006
Last updated
07/05/2024
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