Robert Nolan Brackenrich, DO | |
101 Saint Josephs Candler Dr Ste 200, Pooler, GA 31322-9585 | |
(912) 748-1999 | |
Not Available |
Full Name | Robert Nolan Brackenrich |
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Gender | Male |
Speciality | Family Medicine |
Location | 101 Saint Josephs Candler Dr Ste 200, Pooler, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215559687 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 97632 (Georgia) | Primary |
Entity Name | Sjc Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1811233828 PECOS PAC ID: 7719978105 Enrollment ID: O20040524000690 |
Mailing Address | Practice Location Address |
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Robert Nolan Brackenrich, DO 101 Saint Josephs Candler Dr Ste 200, Pooler, GA 31322-9585 Ph: (912) 748-1999 | Robert Nolan Brackenrich, DO 101 Saint Josephs Candler Dr Ste 200, Pooler, GA 31322-9585 Ph: (912) 748-1999 |
Dolores J Haviland-foley, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 St. Joseph's Candler Drive, Suite 200, Pooler, GA 31322 Phone: 912-748-1999 Fax: 912-748-3847 | |
Tia Bingham Vincent, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 Saint Josephs Candler Dr Ste 200, Pooler, GA 31322 Phone: 912-748-1999 Fax: 912-527-1002 | |
Dr. Wesley Don Ensley, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Towne Center Blvd Bldg 1200, Pooler, GA 31322 Phone: 912-748-2280 Fax: 912-748-4988 | |
Lawrence F Zottoli, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 St. Joseph Candler Drive, Suite 200, Pooler, GA 31322 Phone: 912-748-1999 Fax: 912-748-3847 | |
Dr. Russell Lee Sliker, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Towne Center Blvd Ste 701, Pooler, GA 31322 Phone: 912-748-2280 Fax: 912-748-4988 | |
Dr. Michael Robert Cohen, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Towne Center Blvd, Suite 701, Pooler, GA 31322 Phone: 912-748-2280 Fax: 912-748-4988 |