Individual
MICHAEL BRADY PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
206 OXFORD RD, NEW ALBANY, MS 38652-3115
(662) 534-2227
(662) 534-2330
Mailing address
1725 HIGHWAY 30 WEST, MYRTLE, MS 38650
(662) 534-4451
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PENDING
MS
Other
Enumeration date
04/12/2007
Last updated
06/20/2008
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