Provider Demographics
NPI:1669444006
Name:BRACHER, GEORGE ALAN (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ALAN
Last Name:BRACHER
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 1:875 S DOBSON RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5710
Mailing Address - Country:US
Mailing Address - Phone:480-899-9800
Mailing Address - Fax:480-899-2994
Practice Address - Street 1:875 S DOBSON RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5710
Practice Address - Country:US
Practice Address - Phone:480-899-9800
Practice Address - Fax:480-899-2994
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25624207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
69462Medicare ID - Type Unspecified