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Individual

DR. WOODROW WILSON BRAND III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
806 EARL FRYE BLVD, AMORY, MS 38821
(662) 256-8479
(662) 256-1177
Mailing address
10996 FOUR SEASONS PL, STE 100A, CROWN POINT, IN 46307-8685
(662) 256-8479
(662) 256-1177

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
12093
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009306530
AL
05
0111887
MS
Enumeration date
10/18/2006
Last updated
04/01/2019
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