Provider Demographics
NPI:1043348451
Name:BRAUN, ELEANOR FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:FRANCES
Last Name:BRAUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELEANOR
Other - Middle Name:FRANCES
Other - Last Name:BRAUN-EADS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5120 DIXIE HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-1702
Mailing Address - Country:US
Mailing Address - Phone:502-448-7853
Mailing Address - Fax:502-448-0201
Practice Address - Street 1:5120 DIXIE HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-1702
Practice Address - Country:US
Practice Address - Phone:502-448-7853
Practice Address - Fax:502-448-0201
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY42326208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100074960Medicaid
IN200951990Medicaid
KY7100074960Medicaid