| Mr Bradley Martin, PA-C | |
|
815 Highway 51 N, Brookhaven, MS 39601-2079 | |
| (601) 554-7400 | |
| Not Available |
| Full Name | Mr Bradley Martin |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 22 Years |
| Location | 815 Highway 51 N, Brookhaven, Mississippi |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841249489 | NPI | - | NPPES |
| 06974850 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | PA00053 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| King's Daughters Medical Center-brookhaven | Brookhaven, MS | Hospital |
| Franklin County Memorial Hospital | Meadville, MS | Hospital |
| Southwest Ms Regional Medical Center | Mccomb, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southern Bone And Joint Specialists, Pa | 1254328818 | 53 |
| Entity Name | Southern Bone & Joint Specialists, PA |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831110725 PECOS PAC ID: 1254328818 Enrollment ID: O20040427000878 |
| Entity Name | Kings Daughters Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043245368 PECOS PAC ID: 3072575539 Enrollment ID: O20041028000174 |
| Entity Name | Bridging Community With Healthcare, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043627987 PECOS PAC ID: 9537380944 Enrollment ID: O20141029001047 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Bradley Martin, PA-C 3688 Veterans Memorial Dr Ste 200, Hattiesburg, MS 39401-8246 Ph: (601) 554-7400 | Mr Bradley Martin, PA-C 815 Highway 51 N, Brookhaven, MS 39601-2079 Ph: (601) 554-7400 |