Bentley, Brandon

Bentley, Brandon is an sole proprietor health care provider with primary practice located at 1120 15Th St , Augusta GA 30912-5857. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Bentley, Brandon can be contacted via phone (706) 721-8623.

Contact Information

Primary practice address
1120 15Th St Augusta GA 30912-5857
Phone: (706) 721-8623
Fax: (706) 721-1459
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME147385 Florida
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 95418 Georgia

Profile Details

NPI number 1407415797
LBN Legal business name Bentley, Brandon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 10th, 2019
Last updated Jul 18th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407415797 NPPES
Florida MEDICAID 108673700

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