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Individual

BRANDON J CRAFT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
2080 S FRONTAGE RD, VICKSBURG, MS 39180-5328
(601) 262-1000
(601) 262-1009
Mailing address
2550 FLOWOOD DR, STE. 402, FLOWOOD, MS 39232-9303
(601) 936-3100
(601) 936-3130

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R862029
MS
363LA2100X
Acute Care Nurse Practitioner
R862029
MS
363LF0000X
Family Nurse Practitioner
Primary
862029
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06672579
MS
05
1351237
LA
Enumeration date
05/29/2007
Last updated
07/08/2020
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