Martin, Bradley

Martin, Bradley is an individual health care provider with primary practice located at 1014 Biglane Drive , Brookhaven MS 39601. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Martin, Bradley can be contacted via phone (601) 823-5276.

Contact Information

Primary practice address
1014 Biglane Drive Brookhaven MS 39601
Phone: (601) 823-5276
Fax: (601) 823-2206
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA00053 Mississippi

Profile Details

NPI number 1841249489
LBN Legal business name Martin, Bradley
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Jan 27th, 2017 - about 8 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 1841249489 NPPES
Mississippi MEDICAID 06974850

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