Brantley, Thomas
Brantley, Thomas is an individual health care provider with primary practice located at 1200 S Farmerville St , Ruston LA 71270-5941. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Brantley, Thomas can be contacted via phone (318) 255-3690.Contact Information
Primary practice address
1200 S Farmerville St
Ruston LA 71270-5941
Phone: (318) 255-3690
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 14867 | Louisiana |
Profile Details
| NPI number | 1578533683 |
|---|---|
| LBN Legal business name | Brantley, Thomas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 23rd, 2006 |
| Last updated | Oct 15th, 2009 - about 15 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578533683 | NPPES |
| Louisiana | MEDICAID | 1316377 |
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