Individual
DEE ANN BRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1121 S CLIFTON AVE, WICHITA, KS 67218-2912
(316) 858-3460
Mailing address
1121 S CLIFTON AVE, WICHITA, KS 67218-2912
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-33340
KS
207Q00000X
Family Medicine Physician
046788
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200672280B
—
KS
Enumeration date
06/18/2007
Last updated
09/13/2021
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