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NPI Code Detail

MEDICARE: MR. NEWTON CRAIG BRACKETT III M.D.

MEDICARE: MR. NEWTON CRAIG BRACKETT III M.D.
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
1208600000XSurgery Physician15994SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083658025
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NEWTON CRAIG BRACKETT III M.D.
Provider Business Mailing Address
First Line : PO BOX 421718
Second Line :
City : GEORGETOWN
State : SC
Zip : 29442-4203
Country : US
Telephone Number : 843-527-7000
Fax Number :
Provider Business Practice Location Address
First Line : 2405 N FRASER ST
Second Line :
City : GEORGETOWN
State : SC
Zip : 29440-7764
Country : US
Telephone Number : 843-651-3308
Fax Number : 843-651-4629
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2006
Last Update Date : 12/03/2025

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