Dr Lucas Alfonso Bracero, MD, MBA | |
400 Court St Ste 100, Charleston, WV 25301-1652 | |
(304) 347-6120 | |
(304) 347-6120 |
Full Name | Dr Lucas Alfonso Bracero |
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Gender | Male |
Speciality | Pain Medicine - Pain Medicine |
Location | 400 Court St Ste 100, Charleston, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699270991 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208VP0000X | Pain Medicine - Pain Medicine | 32685 (West Virginia) | Primary |
Entity Name | Charleston Area Medical Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1124248752 PECOS PAC ID: 3375441637 Enrollment ID: O20031223000426 |
Entity Name | Ths Physician Partners Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1871866806 PECOS PAC ID: 9537316393 Enrollment ID: O20120829000738 |
Mailing Address | Practice Location Address |
---|---|
Dr Lucas Alfonso Bracero, MD, MBA 400 Court St Ste 100, Charleston, WV 25301-1652 Ph: (304) 347-6120 | Dr Lucas Alfonso Bracero, MD, MBA 400 Court St Ste 100, Charleston, WV 25301-1652 Ph: (304) 347-6120 |
Josiah Kenneth Lilly Iii, MD MS Pain Medicine Medicare: Not Enrolled in Medicare Practice Location: 4001 Virginia Ave Se, Charleston, WV 25304 Phone: 304-925-2922 Fax: 304-926-8009 | |
Timothy Ray Deer, MD Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 400 Court St Ste 100, Charleston, WV 25301 Phone: 304-347-6120 Fax: 304-347-6142 |