John H. Braxton
Cardiothoracic Vascular Surgeon
1340 Charles St
Rockford
, Illinois 61104-2200
John H. Braxton
Cardiothoracic Vascular Surgeon
1340 Charles St
Rockford
, Illinois 61104-2200
(779) 696-7150
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About
Features
Specialties
- Cardiothoracic Vascular Surgeon
Languages spoken
- English
Location
First Address
- John H. Braxton
- Po Box 1567
- Rockford, IL
- Zip : 61110-0067
- Phone : (779) 696-7150
Second Address
- John H. Braxton
- 1340 Charles St
- Rockford, IL
- Zip : 61104-2200
- Phone : (779) 696-8800
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208G00000X | Cardiothoracic Vascular Surgeon | 014598 | ME |
| N | 208G00000X | Cardiothoracic Vascular Surgeon | 036144421 | IL |
| N | 208G00000X | Cardiothoracic Vascular Surgeon | 55168 | WI |
| Y | 208G00000X | Cardiothoracic Vascular Surgeon | 70145 | MT |
National Provider Identifier
| NPI | 1073568655 |
|---|---|
| Provider Name | John H. Braxton |
| First Address | Rockford, IL 61110-0067 |
| Second Address | Rockford, IL 61104-2200 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/05/2006 |
| Last Update Date | 28/04/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 336110099 | (05) | ME |
| F64022 | (02) | ME |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.