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
Phone: (904) 282-5474
Fax: (904) 282-5824
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1063437861 | NPPES |
Florida | MEDICAID | 046178400 |
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