Larry R Brazley MD, LTD

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

01032396 Issued in IN

Legal business name

LARRY R BRAZLEY MD, LTD

Practice address

255 E 90TH Dr
Merrillville, IN 46410-8144

Phone

(219) 791-0248

Fax

(219) 791-0251

NPI assigned

Aug 4, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Larry R Brazley, MD

Title

Physician/Owner

Phone

(219) 769-1670

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1821006545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E 86TH AVE",
            "address_2": "PO BOX 10645",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106382",
            "telephone_number": "219-769-1670",
            "fax_number": "219-738-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E 90TH DR",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108144",
            "telephone_number": "219-791-0248",
            "fax_number": "219-791-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY R BRAZLEY MD, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "BRAZLEY",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "219-769-1670",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IN",
            "license": "01032396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100169080",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rheumatology Physician in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Rheumatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.