Provider Demographics
NPI:1255398095
Name:BRASCO, JOSEPH D (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:D
Last Name:BRASCO
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:420 LOWELL DR SE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3754
Mailing Address - Country:US
Mailing Address - Phone:256-536-9031
Mailing Address - Fax:256-539-4240
Practice Address - Street 1:420 LOWELL DR SE
Practice Address - Street 2:SUITE 204
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3754
Practice Address - Country:US
Practice Address - Phone:256-536-9031
Practice Address - Fax:256-539-4240
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2015-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL00027229207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E80202Medicare UPIN
AL51003297OtherBCBS
AL009936174Medicaid
AL009936174Medicaid