Individual
DR. THOMAS NEWBY BRAXTAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
508 MANATEE AVE E, BRADENTON, FL 34208-1146
(941) 744-0024
(941) 746-1048
Mailing address
508 MANATEE AVE E, BRADENTON, FL 34208-1146
(941) 744-0024
(941) 746-1048
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME0050553
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03925
BLUE CROSS BLUE SHIELD
FL
01
—
10482
MONTANA MEDICAL LICENSE
MT
Enumeration date
08/23/2006
Last updated
07/08/2007
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