Provider Demographics
NPI:1407080716
Name:BRAXTON, ERNEST EARL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:EARL
Last Name:BRAXTON
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2472 PATTERSON RD UNIT 8
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1100
Mailing Address - Country:US
Mailing Address - Phone:970-241-0202
Mailing Address - Fax:970-245-0250
Practice Address - Street 1:1140 EDWARDS VILLAGE BLVD STE B-105
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632-5525
Practice Address - Country:US
Practice Address - Phone:970-569-3240
Practice Address - Fax:866-725-4659
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2024-04-10
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Provider Licenses
StateLicense IDTaxonomies
CODR.0058687207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery