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Individual

DR. DAVID LEON BRACKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2250
(859) 572-2326
Mailing address
PO BOX 18667, ERLANGER, KY 41018-0667
(859) 572-3617
(859) 572-2326

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01084307A
IN
207P00000X
Emergency Medicine Physician
Primary
28975
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0949906
OH
05
200975500
IN
05
64055932
KY
Enumeration date
08/02/2005
Last updated
05/27/2021
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