Provider Demographics
NPI:1386930147
Name:FLAGGS, BRITTANY THOMAS (DPT)
Entity type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:THOMAS
Last Name:FLAGGS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:LANETTE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 13814
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39236-3814
Mailing Address - Country:US
Mailing Address - Phone:601-910-7300
Mailing Address - Fax:601-910-7071
Practice Address - Street 1:105 LEXINGTON DR
Practice Address - Street 2:SUITE H
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6645
Practice Address - Country:US
Practice Address - Phone:601-910-7300
Practice Address - Fax:601-910-7071
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT4912208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06303309Medicaid