Individual
BRANDON W SKELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
611 ALCORN DR, CORINTH, MS 38834-9321
(662) 821-1837
(662) 680-5103
Mailing address
PO BOX 2285, CORINTH, MS 38835-2285
(662) 507-2444
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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