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1912343823

NPI Code Detail

MEDICARE: TRACY BRAS MD

MEDICARE: TRACY BRAS 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
1	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	MD22373	ME
2	208100000X	Physical Medicine & Rehabilitation Physician	84058-20	WI
3	208100000X	Physical Medicine & Rehabilitation Physician	84058-20	PA

General Provider Information

NPI Number	:	1912343823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY BRAS MD

Provider Business Mailing Address
First Line	:	9310 S 46TH ST
Second Line	:
City	:	FRANKLIN
State	:	WI
Zip	:	53132-9273
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19525 W NORTH AVE
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53045-4107
Country	:	US
Telephone Number	:	312-635-0973
Fax Number	:

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

Provider Enumeration Date	:	05/18/2013
Last Update Date	:	01/14/2025

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Directions to “ TRACY BRAS MD” Practice Location

Language	Start Address	Practice Location

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