Braeutigam, Kent Thomas

Braeutigam, Kent Thomas is an individual health care provider with primary practice located at 3839 County Road 218 , Middleburg FL 32068-5708. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Braeutigam, Kent Thomas can be contacted via phone (904) 282-5474.

Contact Information

Primary practice address
3839 County Road 218 Middleburg FL 32068-5708
Fax: (904) 282-5824
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS5110 Florida
Allopathic & Osteopathic Physicians / General Practice 208D00000X OS5110 Florida

Profile Details

NPI number 1063437861
LBN Legal business name Braeutigam, Kent Thomas
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated Sep 15th, 2022 - about 2 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 1063437861 NPPES
Florida MEDICAID 046178400

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