Individual
BRANDON CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
(478) 254-5463
Mailing address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
(478) 254-5463
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1580
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1580
STATE BOARD OF MEDICAL EX
GA
Enumeration date
07/12/2007
Last updated
10/15/2025
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