Individual
DR. BRYAN BARKSDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, DEPT OF MEDICINE/DIVISION OF CARDIOLOGY, JACKSON, MS 39216-4500
(601) 984-5687
(601) 984-5638
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5687
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
06380
MS
207RI0011X
Interventional Cardiology Physician
06380
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115734
—
MS
01
—
060021371
RAILROAD MEDICARE
MS
05
—
1587451
—
LA
01
—
P00615907
RAILROAD
MS
Enumeration date
05/09/2006
Last updated
04/11/2019
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