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Contact Information

JARAD J BRADDY, DDS
8747 NORTHWEST DR
SOUTHAVEN, MS38671-2409
 Phone: 662-393-0781
 Fax: 662-342-0750
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for JARAD J BRADDY · (Male)

NPI Number 1831119940
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 07/20/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MS License # 3341-05
  • MS Medicaid 00060134
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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