Individual
DR. PAUL BRACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6841 FERN AVENUE, SUITE 100, SHREVEPORT, LA 71105
(318) 868-2273
Mailing address
PO BOX 5789, SHREVEPORT, LA 71135-5789
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
17686
MS
207P00000X
Emergency Medicine Physician
MD.025069
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05286360
—
MS
Enumeration date
07/08/2006
Last updated
06/23/2021
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