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General NPI Number Information
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NPI Number | 1932410685
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Entity Type | Individual
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Provider Name | BRANDON MARTIN
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Gender | Male
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Dates
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Enumeration Date | 06/28/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2825 W ANDREW JOHNSON HWY
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City | MORRISTOWN
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State | TN
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Zip | 37814-3216
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Country | US
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Telephone | 423-317-5757
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Fax |
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Provider Business Mailing Address
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Address Line | 1505 JOHNSON DR
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City | MORRISTOWN
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State | TN
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Zip | 37814-3358
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Country | US
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Telephone | 423-317-7303
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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 | 26022977A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 33251
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 26022977A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 33251
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License Number State | TN
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