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Individual

DR. CHRISTOPHER W BRACKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
4405 BELLEMEADE AVE STE 101, EVANSVILLE, IN 47714-0682
(812) 474-1010
(812) 485-2476
Mailing address
4405 BELLEMEADE AVE, SUITE 101, EVANSVILLE, IN 47714-0682
(812) 474-1010
(812) 485-2476

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003248A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000368900
ANTHEM BLUE CROSS BLUE SH
IN
01
000000501907
ANTHEM BLUE CROSS BLUE SHIELD
IN
05
200434020A
IN
01
P00277379
RAILROAD MEDICARE
IN
Enumeration date
08/10/2005
Last updated
10/12/2020
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