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NPI Code Detail

MEDICARE: JAMES T BRAUN LPT

MEDICARE: JAMES T BRAUN LPT
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
1225100000XPhysical TherapistPT002412KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000367306OTHERANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699766253
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES T BRAUN LPT
Provider Business Mailing Address
First Line : 4130 DUTCHMANS LN
Second Line : SUITE 300
City : LOUISVILLE
State : KY
Zip : 40207-4713
Country : US
Telephone Number : 502-897-1794
Fax Number : 502-897-0093
Provider Business Practice Location Address
First Line : 4130 DUTCHMANS LN
Second Line : SUITE 300
City : LOUISVILLE
State : KY
Zip : 40207-4713
Country : US
Telephone Number : 502-897-1794
Fax Number : 502-897-0093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 01/09/2015

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