Brent, Charles R

Brent, Charles R is an individual health care provider with primary practice located at 1212 South 28Th Ave , Hattiesburg MS 39402. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurological Surgery, Other Service Providers / Specialist. Other Service Providers / Specialist is his primary health care specialty. Brent, Charles R can be contacted via phone (601) 475-2430.

Contact Information

Primary practice address
1212 South 28Th Ave Hattiesburg MS 39402
Phone: (601) 475-2430
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 9082 Mississippi
Other Service Providers / Specialist 174400000X 09082 Mississippi

Profile Details

NPI number 1063513141
LBN Legal business name Brent, Charles R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Mar 28th, 2022 - about 4 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 1063513141 NPPES
Mississippi MEDICAID 0113775

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