Provider Demographics
NPI:1467033100
Name:STIFF, BRANDON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:STIFF
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2464 FORTUNE DR STE 165
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-4254
Mailing Address - Country:US
Mailing Address - Phone:859-543-1719
Mailing Address - Fax:859-543-2066
Practice Address - Street 1:2464 FORTUNE DR STE 165
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-4254
Practice Address - Country:US
Practice Address - Phone:859-543-1719
Practice Address - Fax:859-543-2066
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist