Individual
MR. TED MORAN BRAXLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN 053898 NP
Contact information
Practice address
811 HEMLOCK ST, MACON, GA 31201-2144
(478) 751-6120
(478) 751-6099
Mailing address
811 HEMLOCK ST, MACON, GA 31201-2144
(478) 751-6120
(478) 751-6099
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN 53898 NP
GA
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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