Organization
T. KEVIN BRASWELL, MD P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LAURA TRUSTY (INSURANCE MANAGER)
(662) 226-2030
Entity
Organization
Contact information
Practice address
990 AVENT DR, GRENADA, MS 38901-5002
(662) 226-2030
(662) 227-1236
Mailing address
990 AVENT DR, GRENADA, MS 38901-5002
(662) 226-2030
(662) 227-1236
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00112536
—
MS
Enumeration date
11/26/2007
Last updated
05/16/2008
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