Provider Demographics
NPI:1215167150
Name:OAKES, LUTHER BRANDON (MD)
Entity type:Individual
Prefix:
First Name:LUTHER
Middle Name:BRANDON
Last Name:OAKES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 LISA DRIVE EXT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38703-4429
Mailing Address - Country:US
Mailing Address - Phone:662-335-3252
Mailing Address - Fax:662-269-4480
Practice Address - Street 1:1907 LISA DRIVE EXT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38703
Practice Address - Country:US
Practice Address - Phone:662-335-3252
Practice Address - Fax:662-269-4480
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS22238207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine