Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 04-17786 | KS |
N | 208D00000X | General Practice Physician | R7606 | MO |
NPI | 1932432754 |
---|---|
Provider Name | William J Braun |
First Address | Topeka, KS 66606-2084 |
Second Address | Topeka, KS 66606-2084 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2009 |
Last Update Date | 12/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100117240C | (05) | KS |
110661009 | MEDICARE PTAN (01) | KS |