Tollefson, Brian J

Tollefson, Brian J is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Tollefson, Brian J can be contacted via phone (601) 984-5571.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-5571
Fax: (601) 984-5583
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 18987 Mississippi
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 18987 Mississippi

Profile Details

NPI number 1093747776
LBN Legal business name Tollefson, Brian J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Mar 24th, 2023 - about 2 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 1093747776 NPPES
Mississippi Other P00772006 RAILROAD NUMBER
Mississippi MEDICAID 178297 RAILROAD NUMBER
Mississippi Other 512I930490 RAILROAD NUMBER
Mississippi MEDICAID 1796778 RAILROAD NUMBER

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