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1184047904
MICHAEL LUCAS BRASEL
JACKSON, MS
NPI
1184047904
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: MS pa00197)
Enumeration Date
2014-01-30
Last Update Date
2014-01-30
Business Address
-- MICHAEL LUCAS BRASEL PA-C
1777 ELLIS AVE
JACKSON, MS 39204-3616
Phone number: 601-371-0400
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Mailing Address
-- MICHAEL LUCAS BRASEL PA-C
4092 HIGHWAY 472
HAZLEHURST, MS 39083-9650
Phone number: 601-894-4825
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