Provider Demographics
NPI:1447230933
Name:BRACKINS, TOMMY JASON (PA-C)
Entity Type:Individual
Prefix:
First Name:TOMMY
Middle Name:JASON
Last Name:BRACKINS
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:COMDT (CG-1122) U.S. COAST GUARD
Mailing Address - Street 2:2100 2ND ST SW SUITE 5314
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:865-599-8870
Mailing Address - Fax:865-599-8870
Practice Address - Street 1:COMDT (CG-1122) U.S. COAST GUARD
Practice Address - Street 2:2100 2ND ST SW SUITE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:305-953-2261
Practice Address - Fax:305-953-2251
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2016-05-26
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant