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Contact Information

KENNETH M BRANTLEY, MD
1801 N SENATE BLVD
STE 230
INDIANAPOLIS, IN46202-1252
 Phone: 317-962-5820
 Fax: 317-962-3916
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Critical Care Medicine

207RC0200X 11 Physician/Internal Medicine
 

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KENNETH M BRANTLEY · (Male)

NPI # 1609825017
Status Active
Credentials MD
Entity Individual
Enumeration date 05/10/2006
Last updated 02/07/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01071672A
  • NV License # 6726
  • IN Medicaid 201165820
  • NV Medicaid 2019408
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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