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DR. BRENT ANDREW TREADWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(610) 984-1000
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
28669
MS
207P00000X
Emergency Medicine Physician
Primary
336356
LA
390200000X
Student in an Organized Health Care Education/Training Program
MS

Other

Enumeration date
04/07/2019
Last updated
02/19/2025
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