Individual
JOHN BRETTON BRANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5220 FLANDERS DRIVE, BATON ROUGE, LA 70808
(225) 766-5151
(225) 766-8216
Mailing address
5220 FLANDERS DRIVE, BATON ROUGE, LA 70808
(225) 766-5151
(225) 766-8216
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
013362
LA
207NP0225X
Pediatric Dermatology Physician
013362
LA
207NS0135X
Procedural Dermatology Physician
013362
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1168122
—
LA
Enumeration date
06/29/2006
Last updated
02/09/2010
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