Bracken, David Leon

Bracken, David Leon is an individual health care provider with primary practice located at 1 Medical Village Dr , Edgewood KY 41017-3403. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Bracken, David Leon can be contacted via phone (859) 301-2250.

Contact Information

Primary practice address
1 Medical Village Dr Edgewood KY 41017-3403
Fax: (859) 572-2326
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 01084307A Indiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 28975 Kentucky

Profile Details

NPI number 1164423174
LBN Legal business name Bracken, David Leon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated May 27th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164423174 NPPES
Ohio MEDICAID 0949906
Ohio MEDICAID 64055932
Ohio MEDICAID 200975500

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