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NPI Code Detail

MEDICARE: DR. LAYNE C BRACY MD

MEDICARE: DR. LAYNE C BRACY MD
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
1207Q00000XFamily Medicine PhysicianMD61598995WA
2207Q00000XFamily Medicine PhysicianDR.0040508CO

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 : 1780660464
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAYNE C BRACY MD
Provider Business Mailing Address
First Line : 203 S ROLLIE AVE
Second Line : BILLING DEPT - CREDENTIALIST
City : FORT LUPTON
State : CO
Zip : 80621-1508
Country : US
Telephone Number : 303-286-4560
Fax Number : 303-286-4589
Provider Business Practice Location Address
First Line : 6255 QUEBEC PKWY
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-4812
Country : US
Telephone Number : 303-286-8900
Fax Number : 303-286-8260
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2005
Last Update Date : 11/25/2024

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Directions to “ DR. LAYNE C BRACY MD” Practice Location

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