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General NPI Number Information
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NPI Number | 1083840425
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Entity Type | Individual
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Provider Name | BRANTLEY MICHAEL UNDERWOOD PHARMD, CSP, BCACP
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Gender | Male
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Dates
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Enumeration Date | 05/29/2009
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 483 W BOCKMAN WAY
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City | SPARTA
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State | TN
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Zip | 38583-1832
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Country | US
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Telephone | 931-836-3230
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Fax | 931-836-3241
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Provider Business Mailing Address
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Address Line | 483 W BOCKMAN WAY
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City | SPARTA
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State | TN
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Zip | 38583-1832
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Country | US
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Telephone | 931-836-3230
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Fax | 931-836-3241
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | PD13265
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | R-16138
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 117751
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License Number State | AK
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Taxonomy #4
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | PH60661034
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 44702
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License Number State | TN
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