Bragg, Jeffrey W.
Bragg, Jeffrey W. is an individual health care provider with primary practice located at 1391 N Baldwin Ave , Marion IN 46952-1913. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bragg, Jeffrey W. can be contacted via phone (765) 662-2534.Contact Information
Primary practice address
1391 N Baldwin Ave
Marion IN 46952-1913
Phone: (765) 662-2534
Fax: (765) 671-7793
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 02000919 | Indiana |
Profile Details
| NPI number | 1518937697 |
|---|---|
| LBN Legal business name | Bragg, Jeffrey W. |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 23rd, 2006 |
| Last updated | Oct 21st, 2020 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518937697 | NPPES |
| Indiana | MEDICAID | 100260500 | |
| Indiana | Other | 000000661496 |
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