Stephenie Brady

Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Okolona, MS

NPI 1700515848 · NPPES record last updated Jun 6, 2022

Key facts

NPI
1700515848
Entity type
Individual (NPI type 1)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
License
PT4999 (MS)
Practice address
512 Rockwell Dr
Okolona, MS 38860-1622
Phone
(662) 447-5777
NPI assigned
Jun 6, 2022
Sex
Female
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

State licenses

LicenseStateTypeSpecialty
PT4999MSMDPhysical Medicine & Rehabilitation Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PT4999 MS Yes

Addresses

Primary practice location

512 Rockwell Dr
Okolona, MS 38860-1622

Mailing address

599C Steed Rd
Ridgeland, MS 39157-1707

Other providers in Okolona, MS

All providers in Okolona, MS · Physical Medicine & Rehabilitation Physician in Mississippi

Sources for this page

Verify at the official NPI Registry.