Individual
DR. BRENT DALEE LIBBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ATTN: MEDICAL STAFF SERVICES BLDG. H 2005 KNIGHT LANE, NAVY MEDICINE SUPPORT COMMAND, JACKSONVILLE, FL 32212-0140
(904) 542-7200
Mailing address
7 PLEASANT PLACE CT, BEAUFORT, SC 29907-1187
(843) 524-0743
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101232281
VA
Other
Enumeration date
01/19/2006
Last updated
02/04/2010
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