NPI 1235519984

Bradley Craig Wilson

Practitioner Independent Duty Corpsman Pascagoula, MS

Practice location

Address: 2807 Montclair Ave, Pascagoula, MS 39567-5287
Phone: (910) 382-5414

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1235519984
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Jun 2015
Record last updated: 8 Jun 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.