Brandon Reid Falk
Individual provider Active NPI Contractor · McComb, MS
NPI 1346623964 · NPPES record last updated Jul 1, 2015
Key facts
- NPI
- 1346623964
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 501 S Locust St
McComb, MS 39648-4336 - Phone
- (601) 684-8111
- NPI assigned
- Jul 1, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
501 S Locust St
McComb, MS 39648-4336
Mailing address
2300 Lincoln Rd
Apt 68
Hattiesburg, MS 39402-3120
Phone (443) 985-0345
Other providers in McComb, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.