MEDICARE: JOSEPH C. BRATTON PH.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
1	103T00000X	Psychologist	104	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	A60408	OTHER	HI	HMSA

General Provider Information

NPI Number	:	1578641775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH C. BRATTON PH.D.

Provider Business Mailing Address
First Line	:	101 AUPUNI ST
Second Line	:	216
City	:	HILO
State	:	HI
Zip	:	96720-4246
Country	:	US
Telephone Number	:	808-934-0544
Fax Number	:	808-934-7634

Provider Business Practice Location Address
First Line	:	101 AUPUNI ST
Second Line	:	216
City	:	HILO
State	:	HI
Zip	:	96720-4246
Country	:	US
Telephone Number	:	808-934-0544
Fax Number	:	808-934-7634

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/08/2007

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Directions to “ JOSEPH C. BRATTON PH.D.” Practice Location

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