Provider Demographics
NPI:1558928929
Name:CHATFIELD, BRANDON (PHARMD)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:CHATFIELD
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 1:11940 WAXWING PL
Mailing Address - Street 2:
Mailing Address - City:APISON
Mailing Address - State:TN
Mailing Address - Zip Code:37302-1400
Mailing Address - Country:US
Mailing Address - Phone:423-260-5433
Mailing Address - Fax:
Practice Address - Street 1:6945 NASHVILLE ST
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2419
Practice Address - Country:US
Practice Address - Phone:706-935-9861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH030998183500000X
TN42187183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist