Individual
DR. ALAN BART BRACKUP
Active
Individual
DR. ALAN BART BRACKUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD044284E
PA
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
MD044284E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0342693000
KEYSTONE
PA
01
—
0520626
PABS (HIGHMARK)
PA
01
—
0790237
CIGNA
PA
01
—
2265859
AETNA HMO
PA
01
—
4122424
AETNA PPO
PA
01
—
520626
PERSONAL CHOICE
PA
01
—
E20626
AMERIHEALTH
PA
Enumeration date
09/04/2006
Last updated
03/25/2021
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