Brazzell, John W

Brazzell, John W is an individual health care provider with primary practice located at 125 S 20Th St , Paducah KY 42001. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Brazzell, John W can be contacted via phone (270) 575-3247.

Contact Information

Primary practice address
125 S 20Th St Paducah KY 42001
Phone: (270) 575-3247
Fax: (270) 442-7335
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 19912 Kentucky
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X 19912 Kentucky
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 19912 Kentucky

Profile Details

NPI number 1447246186
LBN Legal business name Brazzell, John W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2005
Last updated May 4th, 2022 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447246186 NPPES
Kentucky Other P00919781 RR MEDICARE
Kentucky MEDICAID 64199128 RR MEDICARE

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