Individual provider · NPI-1

Dr. Jonathan Nathaniel Brantley, D.P.M.

Podiatrist, Foot & Ankle Surgery · Richmond, VA

NPI number1346299773

StatusActive

Last updated in NPPESFeb 21, 2025

Details

NPI: 1346299773
Entity type: Individual (NPI-1)
Name: Dr. Jonathan Nathaniel Brantley
Credential: D.P.M.
Sex: Male
Sole proprietor: No
Enumeration date: May 10, 2006
Certification date: Feb 21, 2025
Last updated: Feb 21, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
213ES0103X	Podiatrist, Foot & Ankle Surgery	0103000902	VA	Yes

Practice location

1201 Broad Rock Blvd
Surgical Service (112h)
Richmond, VA 23249-0001

Phone 804-675-5112 · Fax 804-675-5390

Mailing address

1201 Broad Rock Blvd
Surgical Service (112h)
Richmond, VA 23249-0001

Phone 804-675-5112 · Fax 804-675-5390

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