Provider Demographics
NPI:1851527485
Name:PERSON, BRETT J (MD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:J
Last Name:PERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 26TH AVE
Mailing Address - Street 2:MERIDIAN ANESTHESIOLOGY GROUP
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-4706
Mailing Address - Country:US
Mailing Address - Phone:601-485-6325
Mailing Address - Fax:
Practice Address - Street 1:4700 26TH AVE
Practice Address - Street 2:MERIDIAN ANESTHESIOLOGY GROUP
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-4706
Practice Address - Country:US
Practice Address - Phone:601-485-6325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS23217207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology