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Individual

LARRY E BRAGG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3515 30TH AVE, KEARNEY, NE 68845-2298
(308) 865-2670
Mailing address
PO BOX 2505, KEARNEY, NE 68848-2505
(308) 865-2230
(308) 238-2254

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
17428
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00403
BCBS
05
47064194502
NE
Enumeration date
10/25/2006
Last updated
01/30/2015
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