Individual
DR. BRADY L RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
220 HIGHWAY 12 W, KOSCIUSKO, MS 39090-3208
(662) 290-3150
(662) 290-3160
Mailing address
220 HIGHWAY 12 W, BAPTIST MED CTR KOSCIUSKO, KOSCIUSKO, MS 39090-3208
(662) 290-3150
(662) 290-3160
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
18287
MS
207Q00000X
Family Medicine Physician
Primary
18287
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03482344
—
MS
Enumeration date
04/10/2006
Last updated
07/24/2019
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