Individual
BRELAND FERRELL' CRUDUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 826-9157
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 826-9157
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
T-5850
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2025
Last updated
07/25/2025
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