Brazley, Larry R
Brazley, Larry R is an sole proprietor health care provider with primary practice located at 255 E 90Th Dr W1, Merrillville IN 46410-8144. He recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as his primary health care specialty. Brazley, Larry R can be contacted via phone (219) 791-0248.Contact Information
Primary practice address
255 E 90Th Dr W1
Merrillville IN 46410-8144
Phone: (219) 791-0248
Fax: (219) 791-0251
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 01032396 | Indiana |
Profile Details
| NPI number | 1093723793 |
|---|---|
| LBN Legal business name | Brazley, Larry R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 4th, 2006 |
| Last updated | Jun 7th, 2011 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093723793 | NPPES |
| Indiana | MEDICAID | 100169080 |
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