Individual
ROBERT B BRAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4 MEDICAL BLVD, HATTIESBURG, MS 39401-7230
(601) 579-5444
(601) 579-5107
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5444
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
06981
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00017068
—
MS
01
—
110005274
RAILROAD MEDICARE
—
05
—
1419915
—
LA
01
—
1558921
AMERICAN ADMIN GROUP
MS
Enumeration date
07/28/2006
Last updated
07/08/2020
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