Braddy, Jarad Joseph
Braddy, Jarad Joseph is an individual health care provider with primary practice located at 8747 Northwest Dr , Southaven MS 38671-2409. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Braddy, Jarad Joseph can be contacted via phone (662) 393-0781.Contact Information
Primary practice address
8747 Northwest Dr
Southaven MS 38671-2409
Phone: (662) 393-0781
Fax: (662) 342-0750
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 3341-05 | Mississippi |
Profile Details
| NPI number | 1831119940 |
|---|---|
| LBN Legal business name | Braddy, Jarad Joseph |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831119940 | NPPES |
| Mississippi | MEDICAID | 00060134 |
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