Brantley, Terry Keith

Brantley, Terry Keith is an individual health care provider with primary practice located at 1850 Chadwick Dr , Jackson MS 39204-3404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Brantley, Terry Keith can be contacted via phone (904) 805-1300.

Contact Information

Primary practice address
1850 Chadwick Dr Jackson MS 39204-3404
Phone: (904) 805-1300
Fax: (904) 805-1302
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 05961 Mississippi

Profile Details

NPI number 1053355040
LBN Legal business name Brantley, Terry Keith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Jul 8th, 2007 - about 17 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1053355040 NPPES
Mississippi Other P00205130 RAILROAD MEDICARE
Mississippi MEDICAID 00014917 RAILROAD MEDICARE

Popular Providers