=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528975919
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ERIC S BRACKETT MD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2026
-----------------------------------------------------
Last Update Date | 08/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9355 WARRICK TRL
-----------------------------------------------------
City | NEWBURGH
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47630-0015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-492-1960
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 5705
-----------------------------------------------------
City | EVANSVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47716-5705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-492-1960
-----------------------------------------------------
Fax | 812-479-7865
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ERIC BRACKETT
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 812-305-4067
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------