Provider Demographics
NPI:1063451128
Name:BURKLEY, BRANDON ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:ROBERT
Last Name:BURKLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8340 BANDFORD WAY STE 109
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2755
Mailing Address - Country:US
Mailing Address - Phone:919-845-0200
Mailing Address - Fax:919-845-0204
Practice Address - Street 1:8340 BANDFORD WAY STE 109
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2755
Practice Address - Country:US
Practice Address - Phone:919-845-0200
Practice Address - Fax:919-845-0204
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4738111N00000X
NYX009296111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU80968Medicare UPIN
NYX5K061Medicare ID - Type Unspecified