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Brandye Wilson, P.A
NPI 1215189618 · on the registry since 2008
Practice
- Address
- 125 Goodman Rd W Ste D
Southaven, MS 38671 - Phone
- (662) 932-3560
- Fax
- (662) 534-2330
- Organisation at this address
- Ortho Express Holding Company, Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363AM0700X
- Licence states on file
- AR, MS
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-09-28
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi