Brandon Holley, MSPAS, PA-C is a medicare enrolled "Physician Assistant" provider in Tupelo, Mississippi. His current practice location is
2434 S Eason Blvd, Tupelo, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(662) 528-4349.
Brandon Holley is licensed to practice in Mississippi (license number PA00433) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1770962698.
Healthcare Provider's Profile
| Full Name | Brandon Holley |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 2434 S Eason Blvd, Tupelo, Mississippi |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1770962698
- Provider Enumeration Date: 05/26/2015
- Last Update Date: 09/18/2019
Medicare PECOS Information:
- PECOS PAC ID: 5496097925
- Enrollment ID: I20190501003194
Medical Identifiers
Medical identifiers for Brandon Holley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770962698 | NPI | - | NPPES |
| 00018203 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | (Tennessee) | Secondary |
| 363A00000X | Physician Assistant | PA00433 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brandon Holley is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Brandon Holley, MSPAS, PA-C
2434 S Eason Blvd,
Tupelo, MS 38804-6942
Ph: (662) 640-4595 | Brandon Holley, MSPAS, PA-C
2434 S Eason Blvd,
Tupelo, MS 38804-6942
Ph: (662) 528-4349 |
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