Individual
WILLIAM JANIKA BRACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-6793
Mailing address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 353-5252
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01087196A
IN
2085R0204X
Vascular & Interventional Radiology Physician
01087196A
IN
390200000X
Student in an Organized Health Care Education/Training Program
26188
MN
Other
Enumeration date
07/10/2014
Last updated
05/24/2024
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