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General NPI Number Information
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NPI Number | 1033970363
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Entity Type | Individual
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Provider Name | BRANDON DOCKERY PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/23/2024
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 4980 PHILLIPS DR
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City | FOREST PARK
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State | GA
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Zip | 30297-1472
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Country | US
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Telephone | 404-362-2990
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Fax |
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Provider Business Mailing Address
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Address Line | 1145 BROOKS RACKLEY RD
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City | DALLAS
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State | GA
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Zip | 30157-9235
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Country | US
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Telephone | 770-842-6955
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH033829
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License Number State | GA
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