Provider Demographics
NPI:1679203269
Name:DOGGETT, BRANDON COREY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:COREY
Last Name:DOGGETT
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 1:2005 HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31719-2123
Mailing Address - Country:US
Mailing Address - Phone:229-938-2649
Mailing Address - Fax:
Practice Address - Street 1:1212 US HIGHWAY 19 S
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-4877
Practice Address - Country:US
Practice Address - Phone:229-431-0569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH033669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist