Wall, Brian Keith

Wall, Brian Keith is an individual health care provider with primary practice located at 2301 S Lamar Blvd , Oxford MS 38655-5373. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Wall, Brian Keith can be contacted via phone (662) 232-8568.

Contact Information

Primary practice address
2301 S Lamar Blvd Oxford MS 38655-5373
Phone: (662) 232-8568
Fax: (662) 513-1450
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 9701190 North Carolina
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 20143 Mississippi

Profile Details

NPI number 1326060070
LBN Legal business name Wall, Brian Keith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2006
Last updated Nov 10th, 2010 - about 15 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 1326060070 NPPES
Mississippi MEDICAID 00680358
Mississippi MEDICAID 891057P

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