Irby, Braxter P

Irby, Braxter P is an individual health care provider with primary practice located at 513C Brookman Dr , Brookhaven MS 39601-2326. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Irby, Braxter P can be contacted via phone (601) 833-3822.

Contact Information

Primary practice address
513C Brookman Dr Brookhaven MS 39601-2326
Fax: (601) 835-4330
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 06205 Mississippi

Profile Details

NPI number 1801877139
LBN Legal business name Irby, Braxter P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2005
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801877139 NPPES
Mississippi MEDICAID 00115941

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