Brodell, Robert T

Brodell, Robert T is an individual health care provider with primary practice located at 2500 North State Street , Jackson MS 39216-4500. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Brodell, Robert T can be contacted via phone (601) 815-3374.

Contact Information

Primary practice address
2500 North State Street Jackson MS 39216-4500
Phone: (601) 815-3374
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 35051453 Ohio
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X 35051453 Ohio
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 22119 Mississippi

Profile Details

NPI number 1598765943
LBN Legal business name Brodell, Robert T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Oct 6th, 2017 - about 7 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 1598765943 NPPES
Mississippi Other P01087832 RAILROAD MEDICARE
Mississippi MEDICAID 08970301 RAILROAD MEDICARE

Popular Providers