Bragg, Traci L

Bragg, Traci L is an individual health care provider with primary practice located at 559 W Twincourt Trl Unit 601 Credentialing Department, St Augustine FL 32095-8805. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bragg, Traci L can be contacted via phone (904) 940-1441.

Contact Information

Primary practice address
559 W Twincourt Trl Unit 601 Credentialing Department St Augustine FL 32095-8805
Phone: (904) 940-1441
Fax: (904) 940-1490
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME89267 Florida

Profile Details

NPI number 1285661736
LBN Legal business name Bragg, Traci L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Nov 4th, 2015 - about 10 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1285661736 NPPES
Florida Other P01113744 RR MEDICARE
Florida MEDICAID 274033800 RR MEDICARE

Popular Providers