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Jason Kelly Brockway, MD
Family Medicine Physician in Kilgore, Texas
NPI 1043283823

Jason Kelly Brockway is a Family Medicine Physician based in Dallas, TX. Jason Kelly Brockway practices in Kilgore, TX and has the professional credentials of MD. The NPI Number for Jason Kelly Brockway is 1043283823 and holds a License No. K0427 (Texas).

The current practice location address for Jason Kelly Brockway is 1718 S Henderson Blvd, Kilgore, TX and can be reached out via phone at 903-983-2110.

Location: 1718 S Henderson Blvd, Kilgore, TX, 75284-6098
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043283823
Provider Name
Jason Kelly Brockway
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1718 S Henderson Blvd, Kilgore, TX, 75284-6098
Phone Number
903-983-2110
Fax Number
Provider Enumeration Date
02/10/2006
Last Update Date
05/18/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
752616977017 01 TX TRICARE CHAMPUS
113244106 05 TX
117311 01 TX SUPERIOR CHIPS
081026902 05 TX
752616977017 01 TX TRICARE
87581G 01 TX BCBS OF TEXAS
113244103 05 TX
117311 01 TX CHIPS
5411635 01 TX AETNA
institution
Provider Business Practice Location Address Details
Address
1718 S Henderson Blvd
City
Kilgore
State
Texas
Zip
75662-3566
Phone Number
903-983-2110
Fax Number
person
Provider Business Mailing Address Details
Address
1718 S Henderson Blvd
City
Kilgore
State
Texas
Zip
75662-3566
Phone Number
903-983-2110
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
K0427 (Texas)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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