Individual
DR. MELISSA JODI BRENTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1512 20TH AVE, MERIDIAN, MS 39301-4124
(601) 483-8300
(601) 484-7776
Mailing address
PO BOX 3780, TUPELO, MS 38803-3780
(601) 483-8300
(601) 484-7776
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
T-2537
MS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
24885
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T-2537
TEMPORARY STATE MEDICAL LICENSE
MS
Enumeration date
06/29/2012
Last updated
01/20/2020
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