Provider Demographics
NPI:1003828013
Name:BRATT, HENRY D (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:D
Last Name:BRATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 E RIVER RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5971
Mailing Address - Country:US
Mailing Address - Phone:520-296-5437
Mailing Address - Fax:520-296-9683
Practice Address - Street 1:1605 E RIVER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-5971
Practice Address - Country:US
Practice Address - Phone:520-296-5437
Practice Address - Fax:520-296-9683
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2013-09-23
Deactivation Date:2008-07-25
Deactivation Code:
Reactivation Date:2013-09-23
Provider Licenses
StateLicense IDTaxonomies
AZ20080207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZE86279Medicare UPIN