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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578533683 NPPES
Louisiana MEDICAID 1316377

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