Individual
SHELBY K BRANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1030 N FLOWOOD DR STE A, FLOWOOD, MS 39232-9532
(601) 387-9005
(601) 387-9006
Mailing address
1030 N FLOWOOD DR STE A, FLOWOOD, MS 39232-9532
(601) 387-9005
(601) 387-9006
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
11700
MS
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
11700
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114322
—
MS
Enumeration date
07/03/2006
Last updated
12/04/2025
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