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General NPI Number Information
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NPI Number | 1750383725
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Entity Type | Individual
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Provider Name | REBECCA P BRACKETT MD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 12/21/2013
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Provider Practice Location Address
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Address Line | 35 MEDICAL CENTER PKWY
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City | AUGUSTA
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State | ME
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Zip | 04330-8160
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Country | US
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Telephone | 207-622-1959
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Fax | 207-430-4007
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Provider Business Mailing Address
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Address Line | 35 MEDICAL CENTER PKWY
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City | AUGUSTA
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State | ME
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Zip | 04330-8160
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Country | US
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Telephone | 207-622-1959
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Fax | 207-430-7007
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 013228
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 013228
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License Number State | ME
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