Provider Demographics
NPI:1205811130
Name:BRAUNLICH, EARL FRITZ (MD)
Entity type:Individual
Prefix:
First Name:EARL
Middle Name:FRITZ
Last Name:BRAUNLICH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8736
Mailing Address - Country:US
Mailing Address - Phone:740-695-1474
Mailing Address - Fax:740-695-1817
Practice Address - Street 1:106 PLAZA DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8736
Practice Address - Country:US
Practice Address - Phone:740-695-1474
Practice Address - Fax:740-695-1817
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22872174400000X, 207X00000X, 207XS0114X
OH35.094820207XS0114X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No174400000XOther Service ProvidersSpecialist
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2853827Medicaid
WV3810012425Medicaid