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Individual

BRANDON W SKELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101240781
VA
2085R0202X
Diagnostic Radiology Physician
21303
MS
2085R0202X
Diagnostic Radiology Physician
46706
TN
390200000X
Student in an Organized Health Care Education/Training Program
0116018271
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03755729
MS
05
1524269
TN
Enumeration date
05/01/2007
Last updated
07/06/2021
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