Larry R Brazley
Rheumatology
255 E 90th Dr W1
Merrillville
, Indiana 46410-8144
Larry R Brazley
Rheumatology
255 E 90th Dr W1
Merrillville
, Indiana 46410-8144
(219) 738-6714
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About
Features
Specialties
- Rheumatology
Languages spoken
- English
Location
First Address
- Larry R Brazley
- 55 E 86th Ave Po Box 10645
- Merrillville, IN
- Zip : 46410-6382
- Fax : (219) 738-6714
- Phone : (219) 769-1670
Second Address
- Larry R Brazley
- 255 E 90th Dr W1
- Merrillville, IN
- Zip : 46410-8144
- Fax : (219) 791-0251
- Phone : (219) 791-0248
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Is Larry R Brazley a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RR0500X | Rheumatology | 01032396 | IN |
National Provider Identifier
| NPI | 1093723793 |
|---|---|
| Provider Name | Larry R Brazley |
| First Address | Merrillville, IN 46410-6382 |
| Second Address | Merrillville, IN 46410-8144 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/08/2006 |
| Last Update Date | 07/06/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 100169080 | (05) | IN |
| C25239 | (02) | IN |
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.