Individual
JEFFREY M BRAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.A.C.S.
Contact information
Practice address
535 E MCKELLIPS RD STE 111, MESA, AZ 85203-2525
(480) 510-3079
(480) 779-1277
Mailing address
6301 S MCCLINTOCK DR STE 115, TEMPE, AZ 85283-3393
(480) 775-8460
(480) 775-8464
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036084373
IL
208600000X
Surgery Physician
Primary
56713
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K50963
MEDICARE PTAN
—
Enumeration date
09/11/2006
Last updated
05/21/2025
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