Individual
LARRY R BRAZLEY
Active
Individual
LARRY R BRAZLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
01032396
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100169080
—
IN
Enumeration date
08/04/2006
Last updated
06/07/2011
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