Brand, Jack W

Brand, Jack W is an individual health care provider with primary practice located at 1720A Medical Park Dr Suite 340, Biloxi MS 39532-2129. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Brand, Jack W can be contacted via phone (228) 392-7429.

Contact Information

Primary practice address
1720A Medical Park Dr Suite 340 Biloxi MS 39532-2129
Phone: (228) 392-7429
Fax: (228) 396-3830
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 11555 Alabama
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 10246 Mississippi

Profile Details

NPI number 1689678674
LBN Legal business name Brand, Jack W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2005
Last updated Jul 19th, 2012 - about 14 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 1689678674 NPPES
Other C02478 GROUP MEDICARE
Other 1194874222 GROUP MEDICARE
MEDICAID 05025093 GROUP MEDICARE

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