Broadnax, Gary

Broadnax, Gary is an individual health care provider with primary practice located at 1289 Broad St , Augusta GA 30901-1187. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Broadnax, Gary can be contacted via phone (706) 724-5557.

Contact Information

Primary practice address
1289 Broad St Augusta GA 30901-1187
Phone: (706) 724-5557
Fax: (706) 724-5293
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1033278361
LBN Legal business name Broadnax, Gary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2006
Last updated Nov 12th, 2010 - about 15 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 1033278361 NPPES
Georgia Other 586045874 PEACHSTATE HEALTH PLAN
Georgia Other 586045874 PEACHSTATE HEALTH PLAN
Georgia Other 586045874 PEACHSTATE HEALTH PLAN
Georgia Other 586045874 PEACHSTATE HEALTH PLAN
Georgia Other 586045874 PEACHSTATE HEALTH PLAN
Georgia Other 586045874 PEACHSTATE HEALTH PLAN
Georgia Other 586045874 PEACHSTATE HEALTH PLAN
Georgia Other G16213 PEACHSTATE HEALTH PLAN

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