Brandon Hb Medical Services LLC
Clinic/Center, Multi-Specialty in Brandon, MS. Organization (NPI-2).
NPI number1801576830
StatusActive
Last updated in NPPESJul 24, 2023
Details
- NPI
- 1801576830
- Entity type
- Organization (NPI-2)
- Legal business name
- Brandon Hb Medical Services LLC
- Organization subpart
- No
- Enumeration date
- Jul 24, 2023
- Certification date
- Jul 24, 2023
- Last updated
- Jul 24, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | Yes |
| 208M00000X | Hospitalist | – | – | |
| 261QE0002X | Clinic/Center, Emergency Care | – | – |
Practice location
350 Crossgates BlvdBrandon, MS 39042-2601
Phone 601-825-2811 · Fax 601-376-1816
Mailing address
Po Box 689022Franklin, TN 37068-9022
Phone 615-465-7361 · Fax 615-628-6877
Authorized official
Jennifer Jackson
Senior Director Provider Enrollment
6154653334
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