Greenhaw, Bradley Noel

Greenhaw, Bradley Noel is an sole proprietor health care provider with primary practice located at 516 Pegram Dr , Tupelo MS 38801-6347. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Greenhaw, Bradley Noel can be contacted via phone (662) 844-6272.

Contact Information

Primary practice address
516 Pegram Dr Tupelo MS 38801-6347
Phone: (662) 844-6272
Fax: (662) 844-1603
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 23810 Mississippi
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 23810 Mississippi
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 23810 Mississippi

Profile Details

NPI number 1215249131
LBN Legal business name Greenhaw, Bradley Noel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 8th, 2010
Last updated May 19th, 2015 - about 9 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 1215249131 NPPES
Mississippi Other T-2318 TEMPORART MS MEDICAL LICENSE NUMBER

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