Bragg, John Earl
Bragg, John Earl is an individual health care provider with primary practice located at 3555 Harden Street Ext Ste 141 , Columbia SC 29203-6894. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Bragg, John Earl can be contacted via phone (803) 434-4300.Contact Information
Primary practice address
3555 Harden Street Ext Ste 141
Columbia SC 29203-6894
Phone: (803) 434-4300
Fax: (803) 434-4277
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 21102 | South Carolina |
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 21102 | South Carolina |
Profile Details
| NPI number | 1790746584 |
|---|---|
| LBN Legal business name | Bragg, John Earl |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 31st, 2006 |
| Last updated | Apr 16th, 2018 - about 6 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 | 1790746584 | NPPES |
| South Carolina | MEDICAID | 211023 |
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