NPI Code Details Logo

NPI 1083658025

NPI 1083658025 : NEWTON CRAIG BRACKETT III M.D. : GEORGETOWN, SC

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1083658025
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    NEWTON CRAIG BRACKETT III M.D.
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/16/2006
-----------------------------------------------------
    Last Update Date     |    12/03/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2405 N FRASER ST 
-----------------------------------------------------
    City                 |    GEORGETOWN
-----------------------------------------------------
    State                |    SC
-----------------------------------------------------
    Zip                  |    29440-7764
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    843-651-3308
-----------------------------------------------------
    Fax                  |    843-651-4629
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 421718 
-----------------------------------------------------
    City                 |    GEORGETOWN
-----------------------------------------------------
    State                |    SC
-----------------------------------------------------
    Zip                  |    29442-4203
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    843-527-7000
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    208600000X
-----------------------------------------------------
    Taxonomy Name        |    Surgery Physician
-----------------------------------------------------
    License Number       |    15994
-----------------------------------------------------
    License Number State |    SC
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.