Provider Demographics
NPI:1083658025
Name:BRACKETT, NEWTON CRAIG III (MD)
Entity Type:Individual
Prefix:MR
First Name:NEWTON
Middle Name:CRAIG
Last Name:BRACKETT
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:4181 HWY 17 BYPASS
Mailing Address - Street 2:P O BOX 1327
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576
Mailing Address - Country:US
Mailing Address - Phone:843-657-3308
Mailing Address - Fax:843-357-1471
Practice Address - Street 1:4181 HWY 17 BYPASS
Practice Address - Street 2:COASTAL CAROLINA BREAST CENTER LLC
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576
Practice Address - Country:US
Practice Address - Phone:843-651-3308
Practice Address - Fax:843-357-1471
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2013-02-14
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Provider Licenses
StateLicense IDTaxonomies
SC15994208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC15994Medicaid
SC15994Medicaid