person
Dr. Jerry W Brackett, MD
General Practice Physician in Berea, Kentucky
NPI 1033165394

Jerry W Brackett is a General Practice Physician based in Berea, KY. Jerry W Brackett practices in Berea, KY and has the professional credentials of MD. The NPI Number for Jerry W Brackett is 1033165394 and holds a License No. 14390 (Kentucky).

The current practice location address for Jerry W Brackett is 607 Chestnut St, Berea, KY and can be reached out via phone at 859-582-9331 and via fax at 606-789-5600.

Location: 607 Chestnut St, Berea, KY, 40403-1514
person
Provider Profile Details
NPI Number
1033165394
Provider Name
Jerry W Brackett
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
607 Chestnut St, Berea, KY, 40403-1514
Phone Number
859-582-9331
Fax Number
606-789-5600
Provider Enumeration Date
05/26/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000059655 01 KY ANTHEM
64143902 05 KY
611139169 01 KY HUMANA
340002395 01 KY RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
607 Chestnut St
City
State
Zip
40403-1514
Phone Number
859-582-9331
Fax Number
606-789-5600
person
Provider Business Mailing Address Details
Address
607 Chestnut St
City
State
Zip
40403-1514
Phone Number
859-582-9331
Fax Number
606-789-5600
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
14390 (Kentucky)
Definition
Definition to come...
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