Craft, Brandon J

Craft, Brandon J is an individual health care provider with primary practice located at 2080 S Frontage Rd , Vicksburg MS 39180-5328. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Craft, Brandon J can be contacted via phone (601) 262-1000.

Contact Information

Primary practice address
2080 S Frontage Rd Vicksburg MS 39180-5328
Phone: (601) 262-1000
Fax: (601) 262-1009
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X R862029 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X R862029 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 862029 Mississippi

Profile Details

NPI number 1245431493
LBN Legal business name Craft, Brandon J
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2007
Last updated Jul 8th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245431493 NPPES
Louisiana MEDICAID 1351237
Louisiana MEDICAID 06672579

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