Dr. Brian Thomas Distante , MD
Specialist • Vicksburg, MS
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Brian Distante has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Brian Distante, MD was a registered Specialist practicing in Vicksburg, MS. Throughout an active medical career spanning 16 years, Dr. Distante provided care at the practice location at 2100 HIGHWAY 61 N until profile deactivation on 2023-05-31.
Practice Location & Contact Primary Location
2100 Highway 61 N
Vicksburg, MS 391838211
Specialty Benchmarks & Practice Insights
Comparative analytics for Specialist in Vicksburg, MS
Practicing in Vicksburg, MS (253 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 174400000X
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Nurse Anesthetist, Certified Registered
Certified Registered Nurse Anesthetist
Obstetrics & Gynecology
Doctor of Medicine (M.D.)
Emergency Medicine
Doctor of Medicine (M.D.)
Internal Medicine - Nephrology
Doctor of Medicine (M.D.)
Pediatrics
Doctor of Medicine (M.D.)
Specialist/Technologist, Other - Surgical Assistant
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on May 31, 2023
NPI status registered as active in NPPES database
Registered at 2100 HIGHWAY 61 N, VICKSBURG, MS 391838211 (Tel: 6018836071)
Registered at 2100 HIGHWAY 61 N, VICKSBURG, MS 391838211 (Tel: 6018836071)
Recorded as BRIAN DISTANTE, MD
Specialist (License #238522 in NY)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
2100 Highway 61 N
Vicksburg, MS 391838211
Phone: 6018836071
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