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NPI Code Detail

MEDICARE: JOAN L BRAUCKMANN MD

MEDICARE: JOAN L BRAUCKMANN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207K00000XAllergy & Immunology Physician0101055718VA

General Provider Information

NPI Number : 1376585240
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN L BRAUCKMANN MD
Provider Business Mailing Address
First Line : PO BOX 2086
Second Line :
City : SKYLAND
State : NC
Zip : 28776-2086
Country : US
Telephone Number : 828-277-1300
Fax Number : 828-350-2174
Provider Business Practice Location Address
First Line : 1144 PROFESSIONAL DR
Second Line :
City : WILLIAMSBURG
State : VA
Zip : 23185-3330
Country : US
Telephone Number : 757-259-0443
Fax Number : 757-259-0450
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 10/31/2011

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Directions to “ JOAN L BRAUCKMANN MD” Practice Location

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