Individual
DR. THOMAS A BRAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2100 SILVA LN, SUITE A, MOBERLY, MO 65270-3600
(660) 263-7201
(660) 263-2260
Mailing address
2100 SILVA LN, SUITE A, MOBERLY, MO 65270-3600
(660) 263-7201
(660) 263-2260
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R8695
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0104064
UNITED HEALTHCARE
—
05
—
240952853
—
MO
01
—
9580
BLUE CROSS BLUE SHIELD
MO
Enumeration date
08/22/2006
Last updated
09/30/2011
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