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General NPI Number Information
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NPI Number | 1639120389
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Entity Type | Individual
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Provider Name | FRANK W BRAXTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 1349 N MOUNT AUBURN RD
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63701-1727
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Country | US
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Telephone | 573-334-9564
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Fax | 573-334-1879
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Provider Business Mailing Address
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Address Line | 1349 N MOUNT AUBURN RD
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63701-1727
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Country | US
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Telephone | 573-334-9564
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Fax | 573-334-1879
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD018849E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 036-074275
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | D0021892
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | R9D58
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License Number State | MO
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Taxonomy #5
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | N-8307
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License Number State | AR
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