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General NPI Number Information
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NPI Number | 1730399346
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Entity Type | Organization
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Legal Business Name | BRANDON HMA LLC
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 03/22/2010
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Provider Practice Location Address
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Address Line | 350 CROSSGATES BLVD
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City | BRANDON
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State | MS
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Zip | 39042-2601
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Country | US
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Telephone | 601-824-8583
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Fax |
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Provider Business Mailing Address
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Address Line | 350 CROSSGATES BLVD
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City | BRANDON
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State | MS
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Zip | 39042-2601
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Country | US
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Telephone | 601-824-8583
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Fax |
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Authorized Official
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Title or Position | SR. VP AND GENERAL COUNSEL
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Name | TIMOTHY PARRY
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Credential | ESQ
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Telephone | 239-598-3176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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