Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 20080 | AZ |
NPI | 1003828013 |
---|---|
Provider Name | Dr. Henry D Bratt |
First Address | Tucson, AZ 85718-5971 |
Second Address | Tucson, AZ 85718-5971 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 23/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E86279 | (02) | AZ |